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Shi W, Ning Y, Liu X, Liu H, Zhao C, Wu L. Prognostic factors and constructing a nomogram in tracheal cancer patients treated with surgical intervention: A study based on SEER database. Medicine (Baltimore) 2024; 103:e36787. [PMID: 38181293 PMCID: PMC10766228 DOI: 10.1097/md.0000000000036787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/07/2024] Open
Abstract
Although surgery is considered the first choice of treatment for patients diagnosed with tracheal cancer, the prediction of overall survival (OS) in patients undergoing surgical intervention is poor. To address this issue, we developed a nomogram that combined a risk classification system to estimate the OS of patients with tracheal cancer who underwent surgical intervention. A total of 525 qualified patients were selected from the surveillance, epidemiology, and end results database between 1975 and 2018 and were randomly divided into training and validation cohorts (7:3). The parameters of independent prognostic ability were determined using Cox regression analysis, and a nomogram was formed. The predictive ability of the nomogram was tested using the area under the curve of receiver operating characteristic curves and calibration curves. Survival curves were assessed between the different risk classification groups using the Kaplan-Meier method. The results indicated that Age, stage, histology, and tumor size were independent prognostic factors and were included in the predictive model. The calibration plots demonstrated good agreement between the nomogram prediction and actual observation for 24- and 36-month OS. The receiver operating characteristic curves suggested that the predictive model had good discrimination ability, with the area under the curves (training group 0.817, 0.785, and 0.801, respectively) and validation group (0.744, 0.794, and 0.822, respectively). Furthermore, the low-risk group had a better prognosis than the high-risk group in the total, training, and validation cohorts (all P < .001). This study established a novel nomogram system to predict OS and identify independent prognostic factors in patients with tracheal cancer who underwent surgical intervention. This model has the potential to assist doctors in making decisions regarding treatment options.
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Affiliation(s)
- Wei Shi
- Department of Medical Records Management, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Yanhong Ning
- Nephrology Department, The Second People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Xin Liu
- Urinary Surgery Department, The Second People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Hang Liu
- Pulmonary and Critical Care Medicine Department, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning, Guangxi, China
| | - Chunjuan Zhao
- Infectious Diseases Department, The Second People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Liyun Wu
- Infectious Diseases Department, The Second People’s Hospital of Nanning, Nanning, Guangxi, China
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Chen L, Tang K, Wang S, Chen D, Ding K. Predictors of Lymph Node Metastasis in Siewert Type II T1 Adenocarcinoma of the Esophagogastric Junction: A Population-Based Study. Cancer Control 2021; 28:10732748211026668. [PMID: 34155922 PMCID: PMC8226374 DOI: 10.1177/10732748211026668] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Endoscopic resection has been introduced as an alternative treatment for
superficial adenocarcinoma of the esophagogastric junction (AEG), but is
limited by positive nodal status. We aimed to investigate the predictors of
lymph node metastasis (LNM) in patients with Siewert type II T1 AEG. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to
identify eligible patients with Siewert type II T1 AEG. The prevalence of
LNM was assessed. Logistic regression analysis with multivariable adjustment
was used to determine predictors of LNM. We also performed Cox regression
analysis to examine the prognostic value of LNM, which was further confirmed
by competing risk analysis and cumulative incidence function (CIF). Results: In total, 2651 patients with T1 AEG were included, with a median age of 69
years and a median follow-up of 28 months. The overall prevalence of LNM was
17.2% in T1 AEG. When stratified by tumor invasion depth, the prevalence of
LNM was 8.5% for intramucosal tumors and 22.6% for submucosal tumors.
Adjusted logistic regression analysis showed that age, sex, tumor grade,
tumor size and tumor infiltration depth were independent predictors of LNM
in T1 AEG. Multivariate Cox regression analysis revealed that positive nodal
status was significantly associated with worse overall survival and
cancer-specific survival (CSS). Subgroup analysis consistently demonstrated
that patients with LNM had significantly poorer CSS than those without LNM
in most subgroups. Finally, the CIF was calculated, showing that patients
with LNM had a significantly higher cancer-specific death rate than those
without LNM. Conclusions: This population-based study identified age, sex, tumor grade, tumor
infiltration depth and tumor size as independent predictors of LNM in T1
AEG. Considering the high prevalence of LNM in T1 AEG, endoscopic resection
for curative aims may only be introduced in patients without high risks of
LNM.
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Affiliation(s)
- Liubo Chen
- Department of Colorectal Surgery and Oncology, Key Laboratory of
Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang University Cancer Center, Hangzhou, Zhejiang, China
| | - Kejun Tang
- Department of Surgery, Women’s Hospital, School of Medicine,
Zhejiang University, Hangzhou, Zhejiang, China
| | - Sihan Wang
- Cancer Institute (Key Laboratory of Cancer Prevention and
Intervention, China National Ministry of Education, Key Laboratory of Molecular
Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dongdong Chen
- Cancer Institute (Key Laboratory of Cancer Prevention and
Intervention, China National Ministry of Education, Key Laboratory of Molecular
Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Kefeng Ding
- Department of Colorectal Surgery and Oncology, Key Laboratory of
Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang University Cancer Center, Hangzhou, Zhejiang, China
- Kefeng Ding, The Second Affiliated
Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou,
Zhejiang 310009, China.
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Xu F, Yang J, Han D, Huang Q, Li C, Zheng S, Wang H, Lyu J. Nomograms for Estimating Cause-Specific Death Rates of Patients With Inflammatory Breast Cancer: A Competing-Risks Analysis. Technol Cancer Res Treat 2021; 20:15330338211016371. [PMID: 34013802 PMCID: PMC8141985 DOI: 10.1177/15330338211016371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: Inflammatory breast cancer (IBC) is a rare, aggressive and special subtype of primary breast cancer. We aimed to establish competing-risks nomograms to predict the IBC-specific death (BCSD) and other-cause-specific death (OCSD) of IBC patients. Methods: We extracted data on primary IBC patients from the SEER (Surveillance, Epidemiology, and End Results) database by applying specific inclusion and exclusion criteria. Cumulative incidence function (CIF) was used to calculate the cumulative incidence rates and Gray’s test was used to evaluate the difference between groups. Fine-Gray proportional subdistribution hazard method was applied to identify the independent predictors. We then established nomograms to predict the 1-, 3-, and 5-year cumulative incidence rates of BCSD and OCSD based on the results. The calibration curves and concordance index (C-index) were adopted to validate the nomograms. Results: We enrolled 1699 eligible IBC patients eventually. In general, the 1-, 3-, and 5-years cumulative incidence rates of BCSD were 15.3%, 41.0%, and 50.7%, respectively, while those of OCSD were 3.0%, 5.1%, and 7.4%. The following 9 variables were independent predictive factors for BCSD: race, lymph node ratio (LNR), AJCC M stage, histological grade, ER (estrogen receptor) status, PR (progesterone receptor) status, HER-2 (human epidermal growth factor-like receptor 2) status, surgery status, and radiotherapy status. Meanwhile, age, ER, PR and chemotherapy status could predict OCSD independently. These factors were integrated for the construction of the competing-risks nomograms. The results of calibration curves and C-indexes indicated the nomograms had good performance. Conclusions: Based on the SEER database, we established the first competing-risks nomograms to predict BCSD and OCSD of IBC patients. The good performance indicated that they could be incorporated in clinical practice to provide references for clinicians to make individualized treatment strategies.
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Affiliation(s)
- Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Jin Yang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chengzhuo Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, China
| | - Hui Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
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Xu F, Feng X, Zhao F, Huang Q, Han D, Li C, Zheng S, Lyu J. Competing-risks nomograms for predicting cause-specific mortality in parotid-gland carcinoma: A population-based analysis. Cancer Med 2021; 10:3756-3769. [PMID: 33960711 PMCID: PMC8178487 DOI: 10.1002/cam4.3919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Parotid-gland carcinoma (PGC) is a relatively rare tumor that comprises a group of heterogeneous histologic subtypes. We used the Surveillance, Epidemiology, and End Results (SEER) program database to apply a competing-risks analysis to PGC patients, and then established and validated predictive nomograms for PGC. METHODS Specific screening criteria were applied to identify PGC patients and extract their clinical and other characteristics from the SEER database. We used the cumulative incidence function to estimate the cumulative incidence rates of PGC-specific death (GCD) and other cause-specific death (OCD), and tested for differences between groups using Gray's test. We then identified independent prognostic factors by applying the Fine-Gray proportional subdistribution hazard approach, and constructed predictive nomograms based on the results. Calibration curves and the concordance index (C-index) were employed to validate the nomograms. RESULTS We finally identified 4,075 eligible PGC patients who had been added to the SEER database from 2004 to 2015. Their 1-, 3-, and 5-year cumulative incidence rates of GCD were 10.1%, 21.6%, and 25.7%, respectively, while those of OCD were 2.9%, 6.6%, and 9.0%. Age, race, World Health Organization histologic risk classification, differentiation grade, American Joint Committee on Cancer (AJCC) T stage, AJCC N stage, AJCC M stage, and RS (radiotherapy and surgery status) were independent predictors of GCD, while those of OCD were age, sex, marital status, AJCC T stage, AJCC M stage, and RS. These factors were integrated for constructing predictive nomograms. The results for calibration curves and the C-index suggested that the nomograms were well calibrated and had good discrimination ability. CONCLUSION We have used the SEER database to establish-to the best of our knowledge-the first competing-risks nomograms for predicting the 1-, 3-, and 5-year cause-specific mortality in PGC. The nomograms showed relatively good performance and can be used in clinical practice to assist clinicians in individualized treatment decision-making.
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Affiliation(s)
- Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Chengzhuo Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
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