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基于 SEER 数据库的中老年脊索瘤患者预后列线图研究。

Prognostic nomogram in middle-aged and elderly patients with chordoma: A SEER-based study.

机构信息

Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, PR China.

Department of orthopedics, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou Medical Center, Nanjing Medical University, Changzhou, PR China.

出版信息

J Orthop Surg (Hong Kong). 2024 May-Aug;32(2):10225536241254208. doi: 10.1177/10225536241254208.

Abstract

BACKGROUND

Chordoma is a bone tumor that tends to occur in middle-aged and elderly people. It grows relatively slowly but is aggressive. The prognosis of middle-aged and elderly patients with chordoma is quite different from that of young patients with chordoma.

OBJECTIVES

The purpose of the research was to construct a nomogram to predict the Individualized prognosis of middle-aged and elderly (age greater than or equal to 40 years) patients with chordoma.

METHODS

In this study, we screened 658 patients diagnosed with chordoma from 1983 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. We determined the independently prognostic factors that affect the survival of patients by univariate and multivariate Cox proportional hazards model. Based on the independent prognostic factors, we constructed a nomogram to predict the overall survival (OS) rates of middle-aged and elderly patients with chordoma at 3 and 5 years. The validation of this nomogram was completed by evaluating the calibration curve and the C-index.

RESULTS

We screened a total of 658 patients and divided them into two cohort. Training cohort had 462 samples and validation cohort had 196 samples. The multivariate Cox proportional hazards model of the training group showed an association of age, tumor size, histology, primary site, surgery, and extent of disease with OS rates. Based on these results, we constructed the corresponding nomogram. The calibration curve and C-index showed the satisfactory ability of the nomogram in terms of predictive ability.

CONCLUSION

Nomogram can be an effective prognostic tool to assess the prognosis of middle-aged and elderly patients with chordoma and can help clinicians in medical decision-making and enable patients to receive more accurate and reasonable treatment.

摘要

背景

脊索瘤是一种倾向于发生在中老年人的骨肿瘤。它生长相对缓慢,但具有侵袭性。中老年人脊索瘤患者的预后与年轻患者的预后有很大不同。

目的

本研究旨在构建列线图预测中老年人(年龄≥40 岁)脊索瘤患者的个体化预后。

方法

本研究从 1983 年至 2015 年在监测、流行病学和最终结果(SEER)数据库中筛选了 658 例诊断为脊索瘤的患者。我们通过单因素和多因素 Cox 比例风险模型确定了影响患者生存的独立预后因素。基于独立的预后因素,我们构建了一个列线图来预测中老年人脊索瘤患者 3 年和 5 年的总生存率(OS)。通过评估校准曲线和 C 指数来验证该列线图。

结果

我们共筛选了 658 例患者,并将其分为两组。训练队列有 462 例,验证队列有 196 例。训练组的多因素 Cox 比例风险模型显示,年龄、肿瘤大小、组织学、原发部位、手术和疾病程度与 OS 率有关。基于这些结果,我们构建了相应的列线图。校准曲线和 C 指数表明该列线图在预测能力方面具有令人满意的能力。

结论

列线图可以作为评估中老年人脊索瘤患者预后的有效工具,有助于临床医生做出医疗决策,并使患者能够接受更准确和合理的治疗。

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