Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China.
Department of Neonatology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China.
Medicine (Baltimore). 2023 Oct 6;102(40):e35478. doi: 10.1097/MD.0000000000035478.
To investigate the overall survival of post-resection leiomyosarcoma (LMS) patients with lung metastasis, data of post-resection LMS patients with lung metastasis between 2010 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The clinical characteristics and survival data for post-resection LMS patients with lung metastasis at Tianjin Medical University Cancer Hospital & Institute (TJMUCH) between October 2010 and July 2018 were collected. Patients derived from the SEER database and TJMUCH were divided into training and validation cohorts, respectively. Univariate and multivariate Cox regression analyses were performed and a nomogram was established. The area under the curve (AUC) and the calibration curve were used to evaluate the nomogram. A web-based nomogram was developed based on the established nomogram. Eventually, 226 patients from the SEER database who were diagnosed with LMS and underwent primary lesion resection combined with lung metastasis were enrolled in the training cohort, and 17 patients from TJMUCH were enrolled in the validation cohort. Sex, race, grade, tumor size, chemotherapy, and bone metastasis were correlated with overall survival in patients with LMS. The C-index were 0.65 and 0.75 in the SEER and Chinese set, respectively. Furthermore, the applicable AUC values of the ROC curve in the SEER cohort to predict the 1-, 3-, 5- years survival rate were 0.646, 0.682, and 0.689, respectively. The corresponding AUC values in the Chinese cohort were 0.970, 0.913, and 0.881, respectively. The calibration curve showed that the nomogram performed well in predicting the overall survival in post-resection LMS patients with lung metastasis. A web-based nomogram (https://weijunqiang.shinyapps.io/survival_lms_lungmet/) was established. The web-based nomogram (https://weijunqiang.shinyapps.io/survival_lms_lungmet/) is an accurate and personalized tool for predicting the overall survival of post-resection LMS with lung metastasis.
为了研究接受手术切除后发生肺转移的平滑肌肉瘤（LMS）患者的总体生存率，我们从监测、流行病学和最终结果（SEER）数据库中提取了 2010 年至 2016 年间接受手术切除后发生肺转移的 LMS 患者的数据。同时，我们还收集了 2010 年 10 月至 2018 年 7 月在天津医科大学肿瘤医院（TJMUCH）接受手术切除后发生肺转移的 LMS 患者的临床特征和生存数据。SEER 数据库和 TJMUCH 中的患者分别被分为训练集和验证集。我们进行了单变量和多变量 Cox 回归分析，并建立了列线图。采用曲线下面积（AUC）和校准曲线评估列线图。基于建立的列线图，我们开发了一个基于网络的列线图。最终，我们纳入了 226 例来自 SEER 数据库的经组织学诊断为 LMS 并接受了原发灶切除术联合肺转移灶切除术的患者作为训练集，纳入了 17 例来自 TJMUCH 的患者作为验证集。单因素和多因素 Cox 回归分析结果显示，性别、种族、分级、肿瘤大小、化疗和骨转移与 LMS 患者的总体生存相关。SEER 队列和中国队列的 C 指数分别为 0.65 和 0.75。此外，SEER 队列中预测 1、3、5 年生存率的 ROC 曲线的适用 AUC 值分别为 0.646、0.682 和 0.689，中国队列中的 AUC 值分别为 0.970、0.913 和 0.881。校准曲线表明，该列线图在预测接受手术切除后发生肺转移的 LMS 患者的总体生存方面表现良好。我们建立了一个基于网络的列线图（https://weijunqiang.shinyapps.io/survival_lms_lungmet/）。该基于网络的列线图（https://weijunqiang.shinyapps.io/survival_lms_lungmet/）是一种准确且个性化的工具，可用于预测接受手术切除后发生肺转移的 LMS 患者的总体生存率。
