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原发弥漫性间变少突胶质细胞瘤患者总生存和癌症特异性生存预测列线图的构建和验证。

Construction and Validation of Nomograms for Predicting Overall Survival and Cancer-Specific Survival in Patients with Primary Anaplastic Oligodendroglioma.

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

World Neurosurg. 2024 Jul;187:e472-e484. doi: 10.1016/j.wneu.2024.04.111. Epub 2024 Apr 25.

Abstract

OBJECTIVE

Anaplastic oligodendroglioma (AOD) is a rare high-grade central nervous system tumor. The current research on prognostic prediction of AOD remains limited. This study aimed to identify prognostic factors and establish the nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with AOD.

METHODS

Patients diagnosed with AOD between 1992 and 2020 were extracted from the Surveillance, Epidemiology, and End Result database. We performed univariate and multivariate Cox regression analyses to identify independent prognostic factors based on the training group. Kaplan-Meier survival curves were used to compare the impact of various independent factors on patient prognosis. For OS and CSS, the nomograms were constructed and verified by the validation group. Harrell''s concordance index, receiver operating characteristic curves, calibration curves, and decision curve analyses were used to assess the discrimination, consistency, and clinical value of the nomograms.

RESULTS

A total of 1202 AOD patients were enrolled, being randomly divided into training (n = 841) and validation (n = 361) groups (7:3 ratio). Univariate and multivariate Cox analysis identified 4 significant independent factors (tumor site, age, surgery, and chemotherapy). For OS and CSS, Harrell''s concordance index were 0.731 (0.705-0.757) and 0.728 (0.701-0.754) in the training group, 0.688 (0.646-0.731) and 0.684 (0.639-0.729) in the validation group, respectively. Receiver operating characteristic curves and Calibration curves showed good discrimination and consistency, respectively. In addition, the decision curve analyses curves showed the nomograms have good clinical benefits.

CONCLUSIONS

We successfully established the nomograms to predict the OS and CSS for AOD patients. The nomograms showed good performance in prognostic prediction, assisting clinicians in evaluating patient prognosis and personalizing treatment plans.

摘要

目的

间变性少突胶质细胞瘤(AOD)是一种罕见的高级别中枢神经系统肿瘤。目前关于 AOD 预后预测的研究仍然有限。本研究旨在确定预后因素,并建立列线图来预测 AOD 患者的总生存期(OS)和癌症特异性生存期(CSS)。

方法

从监测、流行病学和最终结果数据库中提取 1992 年至 2020 年间诊断为 AOD 的患者。我们在训练组中进行单变量和多变量 Cox 回归分析,以确定独立的预后因素。Kaplan-Meier 生存曲线用于比较各种独立因素对患者预后的影响。对于 OS 和 CSS,通过验证组构建并验证列线图。Harrell 的一致性指数、接收者操作特征曲线、校准曲线和决策曲线分析用于评估列线图的区分度、一致性和临床价值。

结果

共纳入 1202 例 AOD 患者,随机分为训练组(n=841)和验证组(n=361)(7:3 比例)。单变量和多变量 Cox 分析确定了 4 个显著的独立因素(肿瘤部位、年龄、手术和化疗)。对于 OS 和 CSS,训练组的 Harrell 一致性指数分别为 0.731(0.705-0.757)和 0.728(0.701-0.754),验证组分别为 0.688(0.646-0.731)和 0.684(0.639-0.729)。接收者操作特征曲线和校准曲线分别显示出良好的区分度和一致性。此外,决策曲线分析曲线表明,该列线图具有良好的临床效益。

结论

我们成功建立了预测 AOD 患者 OS 和 CSS 的列线图。该列线图在预后预测方面表现良好,有助于临床医生评估患者的预后并制定个性化的治疗计划。

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