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基于监测、流行病学和最终结果数据库及多中心病例的阴茎癌预测模型的开发与验证

Development and validation of a predictive model for penile cancer based on the surveillance, epidemiology, and end results database and multi-center cases.

作者信息

Yang Shujun, Chang Wei, Zhang Bin, Hou Qian, Zhang Biao, Kang Yindong, Yin Yongsheng, Wan Jianghou, Shang Panfeng

机构信息

Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.

Department of Urology, The 940th Hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou, Gansu, China.

出版信息

J Cancer Res Clin Oncol. 2023 Nov;149(15):13665-13676. doi: 10.1007/s00432-023-04784-1. Epub 2023 Jul 31.

Abstract

PURPOSE

Penile cancer (PC) is a great impact on the quality of life and psychological status of patients. This study aimed to construct nomograms using data from the Surveillance, Epidemiology, and End Results (SEER) database to predict overall survival (OS) and cancer-specific survival (CSS) in patients with penile cancer (PC).

METHODS

Patients were divided into a training cohort (n = 634) and a validation cohort (n = 272) in a 7:3 ratio. Independent risk factors influencing the prognosis of PC were screened using univariate and multivariate Cox analyses, and models for predicting PC were developed. Data from 203 patients with PC in four tertiary hospitals in Gansu Province from 2012 to 2021 were externally validated.

RESULTS

Univariate analysis and multivariate analysis showed revealed that the OS-related factors were age, grade, T stage, N stage, M stage and tumor size (p < 0.05); the CSS-related factors were age, mode of surgery, T stage, N stage, M stage and tumor size (p < 0.05). The C-indices of the OS and CSS nomograms in the training cohort were 0.743 [95% confidence interval (CI) (0.714-0.772)] and 0.797 (0.762-0.832), respectively. The C-indices of the OS and CSS nomograms in the internal validation cohort were 0.735 (0.686-0.784) and 0.755 (0.688-0.822), respectively, and those in the external validation cohort were 0.801 (0.746-0.856) and 0.863 (0.812-0.914), respectively. Receiver operating characteristic (ROC) curves, calibration curves, and survival curves all demonstrated good predictive performance of the nomograms.

CONCLUSION

The nomograms for PC were developed using the SEER database. The accuracy and clinical usefulness of the model were validated through a combination of internal and external validations.

摘要

目的

阴茎癌对患者的生活质量和心理状态有重大影响。本研究旨在利用监测、流行病学和最终结果(SEER)数据库的数据构建列线图,以预测阴茎癌(PC)患者的总生存期(OS)和癌症特异性生存期(CSS)。

方法

患者按7:3的比例分为训练队列(n = 634)和验证队列(n = 272)。采用单因素和多因素Cox分析筛选影响PC预后的独立危险因素,并建立PC预测模型。对2012年至2021年甘肃省4家三级医院203例PC患者的数据进行外部验证。

结果

单因素分析和多因素分析显示,与OS相关的因素有年龄、分级、T分期、N分期、M分期和肿瘤大小(p < 0.05);与CSS相关的因素有年龄、手术方式、T分期、N分期、M分期和肿瘤大小(p < 0.05)。训练队列中OS和CSS列线图的C指数分别为0.743 [95%置信区间(CI)(0.714 - 0.772)]和0.797(0.762 - 0.832)。内部验证队列中OS和CSS列线图的C指数分别为0.735(0.686 - 0.784)和0.755(0.688 - 0.822),外部验证队列中分别为0.801(0.746 - 0.856)和0.863(0.812 - 0.914)。受试者工作特征(ROC)曲线、校准曲线和生存曲线均显示列线图具有良好的预测性能。

结论

利用SEER数据库开发了PC列线图。通过内部和外部验证相结合,验证了该模型的准确性和临床实用性。

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