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下颌下腺癌患者总生存的预后因素及新型预测模型:一项基于人群的回顾性队列研究。

Prognostic factors and novel prediction models for overall survival of patients with submandibular gland cancer: A population-based retrospective cohort study.

作者信息

Yang Shan-Shan, Yang Xiong-Gang, Yang Xiao-Hong, Hu Xiao-Hua

机构信息

Department of Prosthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China.

Department of Orthopaedics, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China.

出版信息

Heliyon. 2024 May 9;10(10):e30860. doi: 10.1016/j.heliyon.2024.e30860. eCollection 2024 May 30.

Abstract

BACKGROUND

Accurately predicting the survival rate of submandibular gland cancer (SGC) is of significant importance for guiding treatment decision-making and improving patient outcomes. This study was aimed to identify the independent prognostic factors of overall survival (OS) in SGC patients, and develop novel prediction models to aid clinicians in predicting the survival probability.

MATERIALS AND METHODS

Patients diagnosed with primary SGC after the year 2010 were extracted from SEER database and then randomly allocated into training and test samples in a 7:3 ratio. Uni- and multi-variable COX analyses were employed using the training sample to ascertain independent prognostic factors for OS. Subsequently, graphic and online dynamic nomograms were established basing on the independent prognostic factors. We utilized C-index, calibration curve, receiver operating characteristic (ROC) curve, and area under ROC curve (AUC) value to evaluate the discrimination capacity and the consistency between predicted and actual survival.

RESULTS

A total of 527 SGC patients were included (369 assigned to training group and 158 assigned to test group). The multivariable COX analysis showed that age, sex, marital status, tumor histology, summary stage, metastases to bone, and tumor size were independently associated with OS. Novel graphical and online dynamic (URL: https://yangxg1209.shinyapps.io/overall_survival_submandibular_gland_tumor/) nomograms were established. The C-indices (training: 0.77, 95%CI 0.71-0.84; test: 0.77, 95%CI 0.68-0.85) indicate favorable discrimination ability of the model, and the calibration curves demonstrated favorable consistency between the predicted and actual survival rates.

CONCLUSIONS

Our study identified the independent prognostic factors influencing OS in patients with SGC, and successfully established and validated novel nomograms, which provide accurate prediction of survival rates and allows for personalized risk assessment.

摘要

背景

准确预测下颌下腺癌(SGC)的生存率对于指导治疗决策和改善患者预后具有重要意义。本研究旨在确定SGC患者总生存期(OS)的独立预后因素,并开发新的预测模型以帮助临床医生预测生存概率。

材料与方法

从SEER数据库中提取2010年后诊断为原发性SGC的患者,然后按7:3的比例随机分为训练组和测试组。使用训练样本进行单变量和多变量COX分析,以确定OS的独立预后因素。随后,基于独立预后因素建立图形和在线动态列线图。我们利用C指数、校准曲线、受试者工作特征(ROC)曲线和ROC曲线下面积(AUC)值来评估模型的区分能力以及预测生存与实际生存之间的一致性。

结果

共纳入527例SGC患者(369例分配至训练组,158例分配至测试组)。多变量COX分析显示,年龄、性别、婚姻状况、肿瘤组织学、总分期、骨转移和肿瘤大小与OS独立相关。建立了新的图形和在线动态(网址:https://yangxg1209.shinyapps.io/overall_survival_submandibular_gland_tumor/)列线图。C指数(训练组:0.77,95%CI 0.71 - 0.84;测试组:0.77,95%CI 0.68 - 0.85)表明模型具有良好的区分能力,校准曲线显示预测生存率与实际生存率之间具有良好的一致性。

结论

我们的研究确定了影响SGC患者OS的独立预后因素,并成功建立和验证了新的列线图,该列线图可准确预测生存率并实现个性化风险评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b0/11107196/d232488ed6dc/gr1.jpg

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