General Surgery Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China.
J Cancer Res Clin Oncol. 2023 Oct;149(13):11735-11748. doi: 10.1007/s00432-023-05052-y. Epub 2023 Jul 5.
Retroperitoneal leiomyosarcoma is a type of carcinoma with low incidence and poor prognosis, and prognostic factors are currently unknown. Therefore, our study aimed to investigate the predictive factors of RPLMS and establish prognostic nomograms.
Patients diagnosed with RPLMS between 2004 and 2017 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors were identified by univariate and multivariate COX regression analyses and used to generate nomograms to predict overall survival (OS) and cancer-specific survival (CSS).
646 eligible patients were randomly divided into training set (n = 323) and validation set (n = 323). Multivariate COX regression analysis indicated that the independent risk factors for OS and CSS were age, tumor size, grade, SEER stage, and surgery. In the nomogram of OS, the concordance indices (C-index) of the training and validation sets were 0.72 and 0.691, and in the nomogram of CSS, the C-indices of the training and validation sets were 0.737 and 0.737. Furthermore, calibration plots showed that the predicted results of the nomograms in the training and validation sets agree well with the actual observations.
Age, tumor size, grade, SEER stage, and surgery were independent prognostic factors for RPLMS. The nomograms developed and validated in this study can accurately predict the OS and CSS of patients, which could help clinicians make individualized survival predictions. Finally, we make the two nomograms into two web calculators for the convenience of clinicians.
腹膜后平滑肌肉瘤(RPLMS)是一种发病率低、预后差的癌,目前其预后因素尚不清楚。因此,本研究旨在探讨 RPLMS 的预测因素,并建立预后列线图。
从监测、流行病学和最终结果(SEER)数据库中选择 2004 年至 2017 年期间诊断为 RPLMS 的患者。通过单因素和多因素 COX 回归分析确定预后因素,并用于生成预测总生存期(OS)和癌症特异性生存期(CSS)的列线图。
共纳入 646 例符合条件的患者,随机分为训练集(n=323)和验证集(n=323)。多因素 COX 回归分析表明,OS 和 CSS 的独立危险因素为年龄、肿瘤大小、分级、SEER 分期和手术。在 OS 列线图中,训练集和验证集的一致性指数(C-index)分别为 0.72 和 0.691,在 CSS 列线图中,训练集和验证集的 C-index 分别为 0.737 和 0.737。此外,校准图显示,训练集和验证集列线图的预测结果与实际观察结果吻合良好。
年龄、肿瘤大小、分级、SEER 分期和手术是 RPLMS 的独立预后因素。本研究建立和验证的列线图可以准确预测患者的 OS 和 CSS,有助于临床医生进行个体化的生存预测。最后,我们为了方便临床医生使用,将这两个列线图制作成了两个网络计算器。