Department of Radiation Oncology, Taizhou Cancer Hospital, Wenling, Zhejiang, China.
Department of Radiotherapy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Cancer Rep (Hoboken). 2024 Jun;7(6):e2121. doi: 10.1002/cnr2.2121.
The aim was to identify the nutritional indexes, construct a prognostic model, and develop a nomogram for predicting individual survival probability in pan-cancers.
Nutritional indicators, clinicopathological characteristics, and previous major treatment details of the patients were collected. The enrolled patients were randomly divided into training and validation cohorts. Least absolute shrinkage and selection operator (Lasso) regression cross-validation was used to determine the variables to include in the cox regression model. The training cohort was used to build the prediction model, and the validation cohort was used to further verify the discrimination, calibration, and clinical effectiveness of the model.
A total of 2020 patients were included. The median OS was 56.50 months (95% CI, 50.36-62.65 months). In the training cohort of 1425 patients, through Lasso regression cross-validation, 13 characteristics were included in the model. Cox proportional hazards model was developed and visualized as a nomogram. The C-indexes of the model for predicting 1-, 3-, 5-, and 10-year OS were 0.848, 0.826, 0.814, and 0.799 in the training cohort and 0.851, 0.819, 0.814, and 0.801 in the validation cohort. The model showed great calibration in the two cohorts. Patients with a score of less than 274.29 had a better prognosis (training cohort: HR, 6.932; 95% CI, 5.723-8.397; log-rank p < 0.001; validation cohort: HR, 8.429; 95% CI, 6.180-11.497; log-rank p < 0.001).
The prognostic model based on the nutritional indexes of pan-cancer can divide patients into different survival risk groups and performed well in the validation cohort.
本研究旨在确定营养指标,构建预测模型,并制定用于预测泛癌患者个体生存概率的列线图。
收集患者的营养指标、临床病理特征和既往主要治疗细节。将入组患者随机分为训练和验证队列。使用最小绝对收缩和选择算子(Lasso)回归交叉验证确定纳入 Cox 回归模型的变量。使用训练队列构建预测模型,并使用验证队列进一步验证模型的区分度、校准度和临床有效性。
共纳入 2020 例患者。中位总生存期(OS)为 56.50 个月(95%CI,50.36-62.65 个月)。在 1425 例患者的训练队列中,通过 Lasso 回归交叉验证,有 13 个特征纳入模型。建立了 Cox 比例风险模型,并以列线图的形式可视化。该模型预测 1、3、5 和 10 年 OS 的 C 指数在训练队列中分别为 0.848、0.826、0.814 和 0.799,在验证队列中分别为 0.851、0.819、0.814 和 0.801。该模型在两个队列中均具有很好的校准度。评分低于 274.29 的患者具有更好的预后(训练队列:HR,6.932;95%CI,5.723-8.397;对数秩检验 p<0.001;验证队列:HR,8.429;95%CI,6.180-11.497;对数秩检验 p<0.001)。
基于泛癌营养指标的预后模型可以将患者分为不同的生存风险组,并且在验证队列中表现良好。