National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Endocrinol (Lausanne). 2024 Sep 6;15:1432787. doi: 10.3389/fendo.2024.1432787. eCollection 2024.
This study aimed to develop nomogram predicting overall survival (OS) of patients with peritoneal mesothelioma (PeM) using data from Surveillance, Epidemiology, and End Results (SEER) database and a Chinese institution.
1,177 PeM patients from the SEER database were randomized into training and internal validation cohorts at a 7:3 ratio. An external validation cohort consisting of 109 patients was enrolled from a Chinese institution. Nomogram was constructed based on variables identified through multivariate Cox regression analysis and evaluated by consistency indices (C-index), calibration plots, and receiver operating characteristic (ROC) curves. Patients were stratified into different risk categories, and Kaplan-Meier survival analysis was used to assess OS differences among these groups.
The nomogram, incorporating age, gender, histological type, T stage, M stage, and surgical status, demonstrated strong predictive capability with C-index values of 0.669 for the training cohort, 0.668 for the internal validation cohort, and 0.646 for the external validation cohort. The nomogram effectively stratified patients into high-risk and low-risk groups, with the high-risk group exhibiting significantly poorer OS (P < 0.05). Multivariate analysis confirmed gender, age, surgical intervention, and M stage as independent prognostic factors (P < 0.05). Specifically, male gender, older age, and unspecified M stage were linked to worse outcomes, while surgical intervention was associated with improved survival.
The nomogram provide a reliable tool for predicting the survival in PeM patients, facilitating more informed treatment decisions. Key independent prognostic factors include gender, age, surgical intervention, and M stage.
本研究旨在使用来自 SEER 数据库和一家中国机构的数据，开发预测腹膜间皮瘤（PeM）患者总生存期（OS）的列线图。
将 SEER 数据库中的 1177 例 PeM 患者随机分为训练队列和内部验证队列，比例为 7:3。从一家中国机构招募了 109 例患者组成外部验证队列。基于多变量 Cox 回归分析确定的变量构建列线图，并通过一致性指数（C 指数）、校准图和接受者操作特征（ROC）曲线进行评估。将患者分为不同的风险类别，并使用 Kaplan-Meier 生存分析评估这些组之间的 OS 差异。
该列线图纳入了年龄、性别、组织学类型、T 分期、M 分期和手术状态，在训练队列中的 C 指数为 0.669，内部验证队列中的 C 指数为 0.668，外部验证队列中的 C 指数为 0.646，具有较强的预测能力。该列线图能够有效地将患者分为高风险和低风险组，高风险组的 OS 明显较差（P<0.05）。多变量分析证实性别、年龄、手术干预和 M 分期是独立的预后因素（P<0.05）。具体而言，男性、年龄较大和未明确的 M 分期与较差的结局相关，而手术干预与生存改善相关。
该列线图为预测 PeM 患者的生存提供了可靠的工具，有助于做出更明智的治疗决策。关键的独立预后因素包括性别、年龄、手术干预和 M 分期。
