Institute of Drug Clinical Trial/GCP Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Oncology, The First People's Hospital of Mianyang, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, China.
Medicine (Baltimore). 2023 Jul 14;102(28):e34313. doi: 10.1097/MD.0000000000034313.
Cervical squamous cell carcinoma (CSCC) is the most common histological type of cervical cancer (CC). And mCSCC is the end stage of CSCC. The aim of this study was to develop prognostic nomograms that provide better predictions for overall survival (OS) and cancer-specific survival (CSS) in mCSCC patients. Data from patients with initially diagnosed mCSCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The nomograms for OS and CSS were constructed based on Cox regression analysis. The validation of the newly established nomograms was evaluated by concordance index (C-index), calibration curves, and decision curve analyses (DCAs). A total of 2198 patients with mCSCC were included and randomly split into training (n = 1539) and validation (n = 659) cohorts in a 7:3 ratio. Multivariate analyses revealed that the prognostic variables significantly related to the OS and CSS were marital status, T stage, brain metastasis, lung metastasis, tumor size, number of positive lymph nodes, chemotherapy, and radiotherapy. The nomograms were constructed based on these factors. The C-index value of the nomograms for predicting OS and CSS was 0.714 and 0.683, respectively. The calibration curves of the nomograms showed good consistency between nomogram prediction and actual survival for both OS and CSS, and the DCAs showed great clinical usefulness of the nomograms. The mCSCC patients were classified into low- and high-risk groups based on the scores from the nomograms. In the validation cohort, mCSCC patients with low-risk had much higher OS and CSS than those with high-risk. We constructed nomograms for predicting the OS and CSS of patients with initially diagnosed mCSCC. Our models had satisfactory predictive performance and could be useful in survival prediction for mCSCC.
宫颈鳞状细胞癌 (CSCC) 是宫颈癌 (CC) 最常见的组织学类型。而广泛转移的宫颈鳞状细胞癌 (mCSCC) 是 CSCC 的终末期。本研究旨在建立预测 mCSCC 患者总生存 (OS) 和癌症特异性生存 (CSS) 的预后列线图。从 2004 年至 2015 年，从监测、流行病学和最终结果 (SEER) 数据库中提取初诊为 mCSCC 的患者数据。基于 Cox 回归分析建立 OS 和 CSS 的列线图。通过一致性指数 (C-index)、校准曲线和决策曲线分析 (DCAs) 评估新建立的列线图的验证。共纳入 2198 例 mCSCC 患者，按 7:3 的比例随机分为训练集 (n=1539) 和验证集 (n=659)。多变量分析显示，与 OS 和 CSS 显著相关的预后变量包括婚姻状况、T 分期、脑转移、肺转移、肿瘤大小、阳性淋巴结数、化疗和放疗。这些因素被用于构建列线图。列线图预测 OS 和 CSS 的 C-index 值分别为 0.714 和 0.683。列线图的校准曲线显示 OS 和 CSS 的预测值与实际生存率之间具有良好的一致性，而 DCA 显示列线图具有很大的临床实用性。根据列线图的评分，mCSCC 患者被分为低危和高危组。在验证队列中，低危组 mCSCC 患者的 OS 和 CSS 明显高于高危组。我们构建了预测初诊 mCSCC 患者 OS 和 CSS 的列线图。我们的模型具有令人满意的预测性能，可用于 mCSCC 的生存预测。
