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预测眼周基底细胞癌复发的危险因素分析及列线图

Risk factors analysis and nomogram for predicting recurrence in periocular basal cell carcinoma.

作者信息

Hou Xincen, Rokohl Alexander C, Berndt Katharina, Li Senmao, Ju Xiaojun, Matos Philomena A Wawer, Fan Wanlin, Heindl Ludwig M

机构信息

Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology, Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany.

出版信息

Can J Ophthalmol. 2025 Jan 13. doi: 10.1016/j.jcjo.2024.12.003.

Abstract

OBJECTIVES

Aim to develop a nomogram to effectively predict the potential for recurrence after surgical resection in patients with periocular basal cell carcinoma (BCC).

METHODS

We conducted a retrospective study involving 329 patients with eyelid BCC. Univariate and multivariate Cox proportional risk regression was used to screen for independent factors affecting BCC recurrence. Kaplan-Meier survival curve analysis was performed to evaluate their impact on prognosis. On the basis of the results obtained from Cox regression analysis, a nomogram was established for the 1-, 2-, and 3-year recurrence-free survival (RFS) rates of BCC.

RESULTS

In this study, a total of 15 patients out of 329 patients (4.6%) developed local recurrence. Multivariate analysis revealed that age, pathological type, previous history of BCC, and the number of surgeries were independent risk factors for BCC recurrence (p < 0.05, respectively). These risk factors were utilized to construct a nomogram to predict postoperative recurrence for these patients. The C-index of the nomogram was 0.867 (95% CI: 0.817-0.916), and the receiver operating characteristic curves were used to assess the discriminatory degree of the nomogram, with area under the curve values of 0.978, 0.870, and 0.916 at 1, 2, and 3 years, respectively. The calibration curves were basically fitted to the ideal curves.

CONCLUSIONS

Age, pathological type, previous history of BCC, and the number of surgeries are significant risk factors for periocular BCC recurrence. Establishing a nomogram related to recurrence risk factors can more accurately predict the recurrence-free survival of individual patients.

摘要

目的

旨在开发一种列线图,以有效预测眼周基底细胞癌(BCC)患者手术切除后复发的可能性。

方法

我们进行了一项回顾性研究,纳入329例眼睑BCC患者。采用单因素和多因素Cox比例风险回归筛选影响BCC复发的独立因素。进行Kaplan-Meier生存曲线分析以评估其对预后的影响。根据Cox回归分析结果,建立BCC 1年、2年和3年无复发生存率(RFS)的列线图。

结果

本研究中,329例患者中有15例(4.6%)发生局部复发。多因素分析显示,年龄、病理类型、既往BCC病史和手术次数是BCC复发的独立危险因素(P均<0.05)。利用这些危险因素构建列线图,以预测这些患者术后复发情况。列线图的C指数为0.867(95%CI:0.817 - 0.916),采用受试者工作特征曲线评估列线图的区分度,1年、2年和3年曲线下面积值分别为0.978、0.870和0.916。校准曲线基本拟合理想曲线。

结论

年龄、病理类型、既往BCC病史和手术次数是眼周BCC复发的重要危险因素。建立与复发危险因素相关的列线图可更准确地预测个体患者的无复发生存情况。

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