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Hu S, Sun C, Chen M, Zhou J. Marital Status as an Independent Prognostic Factor in Patients with Glioblastoma: A Population-Based Study. World Neurosurg 2024; 182:e559-e569. [PMID: 38061540 DOI: 10.1016/j.wneu.2023.11.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND This study was aimed to investigate the effects of marital status on overall survival (OS) and cancer-specific survival (CSS) in patients with glioblastoma (GBM) and to develop nomograms for predicting prognosis in GBM patients. METHODS All patients were selected from the Surveillance, Epidemiology, and End Results cancer registry program. We used propensity score matching to balance the baseline characteristics of married and unmarried patients. The effects of marital status on OS and CSS were then assessed using Kaplan-Meier curves and Cox proportional hazard regression, and the magnitude of each factor was visualized in the form of forest maps. The impact of marriage on the survival of GBM patients was further explored by stratifying several demographic factors. Finally, the nomograms were constructed and verified based on Cox proportional risk regression model. RESULTS A total of 17,517 patients with GBM (11,818 married patients, 67.5%) were enrolled in the study cohort. After propensity score matching, there were 5699 patients in both the married and unmarried groups. Multivariate Cox regression analysis showed that both married and single patients had better OS (married: hazard ratio [HR] 0.824, 95% confidence interval [CI]: 0.788-0.862, P < 0.001; single: HR 0.764, 95% CI: 0.722-0.808, P < 0.001) and CSS (married: HR 0.833, 95% CI: 0.796-0.872, P < 0.001; single: HR 0.761, 95% CI: 0.718-0.806, P < 0.001) than divorced, separated, and widowed patients. CONCLUSIONS Marital status was an independent prognostic factor in patients with GBM. The nomograms constructed in this study could help medical professionals to provide personalized prognostic assessment and treatment decisions for patients with GBM.
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Affiliation(s)
- Shaobo Hu
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China.
| | - Chengfeng Sun
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Maosong Chen
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Jiang Zhou
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
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Chen Y, Tang M, Fu Y, Zhuang X, Wei R, Chen Y. A prognostic nomogram and risk classification system of elderly patients with extraosseous plasmacytoma: a SEER database analysis. J Cancer Res Clin Oncol 2023; 149:17921-17931. [PMID: 37955685 DOI: 10.1007/s00432-023-05492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The survival trends and prognostic factors of patients with extraosseous plasmacytoma (EOP) or extramedullary plasmacytoma (EMP) have not been reported in recent years. The objective of this study was to develop a novel nomogram and risk stratification system for predicting the overall survival (OS) of elderly patients with EOP based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS The demographic characteristics of 900 patients aged 60 years and above, diagnosed with EOP between 2000 and 2019, were extracted from the SEER database. The patient population was randomly divided into a training cohort and an internal validation cohort in a ratio of 7:3. Univariate and multivariate Cox regression analyses were conducted to identify independent predictors of prognosis in elderly EOP patients, followed by developing a nomogram for prognostic assessment. The performance of the model was evaluated through receiver-operating characteristic (ROC) curves, C-index, calibration curves for calibration accuracy assessment, and decision curve analysis (DCA) to assess its clinical utility. All elderly EOP patients were stratified into three risk subgroups by cutoff value utilizing X-tile software based on their total OS scores for comparative analysis purposes. Kaplan-Meier (K-M) survival curve analysis was employed to validate any observed differences in OS among these three risk groups. RESULTS Six factors including age, year of diagnosis, marital status, primary site, surgery, and prior tumor history were identified to be independently predictive of the OS of elderly patients with EOP, and these predictors were included in the construction of the nomogram. The 1-, 3-, and 5-year area under the curves (AUCs) for OS were 0.717, 0.754, and 0.734 in the training cohort and 0.740, 0.730, and 0.765 in the validation cohort, respectively. The C-index values in the two cohorts were 0.695 and 0.690. The calibration curves and DCA exhibit commendable consistency and validity, respectively, thereby demonstrating their robust performance. The training set was stratified into low-, medium-, and high-risk subgroups based on the optimal cutoff points (167.8 and 264.8) identified. The K-M curve and cumulative risk curve exhibited statistically significant disparities in survival rates among the groups. CONCLUSIONS We developed a nomogram and risk classification system, which can serve as an intuitive and effective tool for clinicians to enhance the prediction of OS in elderly EOP patients, thereby facilitating the formulation of more rational and personalized treatment strategies.
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Affiliation(s)
- Ying Chen
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Meiling Tang
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Yuxin Fu
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Xinran Zhuang
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Rongfang Wei
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Yan Chen
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China.
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Morra S, Incesu RB, Scheipner L, Baudo A, Jannello LMI, de Angelis M, Siech C, Goyal JA, Tian Z, Saad F, Califano G, la Rocca R, Capece M, Shariat SF, Ahyai S, Carmignani L, de Cobelli O, Musi G, Tilki D, Briganti A, Chun FKH, Longo N, Karakiewicz PI. Demographics, Clinical Characteristics and Survival Outcomes of Primary Urinary Tract Malignant Melanoma Patients: A Population-Based Analysis. Cancers (Basel) 2023; 15:4498. [PMID: 37760467 PMCID: PMC10527544 DOI: 10.3390/cancers15184498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
All primary urinary tract malignant melanoma (ureter vs. bladder vs. urethra) patients were identified from within the Surveillance, Epidemiology, and End Results (SEER) database 2000-2020. Kaplan-Maier plots depicted the overall survival (OS) rates. Univariable and multivariable Cox regression (MCR) models were fitted to test the differences in overall mortality (OM). In the overall cohort (n = 74), the median OS was 22 months. No statistically significant or clinically meaningful differences were recorded according to sex (female vs. male; p = 0.9) and treatment of the primary (endoscopic vs. surgical; p = 0.6). Conversely, clinically meaningful but not statistically significant (p ≥ 0.05) differences were recorded according to the patient's age at diagnosis (≤80 vs. ≥80 years old; p = 0.2), marital status (married 26 vs. unmarried 16 months; p = 0.2), and SEER stage (localized 31 vs. regional 14 months; p = 0.4), and the type of systemic therapy (exposed 31 vs. not exposed 20 months; p = 0.06). Finally, in univariable and MCR analyses, after adjustment for the SEER stage and type of systemic therapy, tumor origin within the bladder was associated with a three-fold higher OM (Hazard ratio: 3.00; p = 0.004), compared to tumor origin within the urethra. In conclusion, primary urinary tract malignant melanoma patients have poor survival. Specifically, tumor origin within the bladder independently predicted a higher OM, even after adjustment for the SEER stage and systemic therapy status.
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Affiliation(s)
- Simone Morra
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Reha-Baris Incesu
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Lukas Scheipner
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, Medical University of Graz, 8036 Graz, Austria;
| | - Andrea Baudo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Letizia Maria Ippolita Jannello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Università degli Studi di Milano, 20126 Milan, Italy
| | - Mario de Angelis
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Division of Experimental Oncology, Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Carolin Siech
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany;
| | - Jordan A. Goyal
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Roberto la Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, 8036 Graz, Austria;
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, 20097 Milan, Italy;
- Department of Urology, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- Department of Urology, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
| | - Alberto Briganti
- Division of Experimental Oncology, Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Felix K. H. Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany;
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
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