A nomogram for predicting overall survival in patients with low-grade endometrial stromal sarcoma: A population-based analysis.
FIGO criteria-based tumor staging
Low-grade endometrial stromal sarcoma (LG-ESS)
nomogram
overall survival
prognostic model
risk stratification
Journal
Cancer communications (London, England)
ISSN: 2523-3548
Titre abrégé: Cancer Commun (Lond)
Pays: United States
ID NLM: 101723675
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
01
01
2020
revised:
08
02
2020
accepted:
21
05
2020
pubmed:
20
6
2020
medline:
21
8
2021
entrez:
20
6
2020
Statut:
ppublish
Résumé
Low-grade endometrial stromal sarcoma (LG-ESS) is a rare tumor that lacks a prognostic prediction model. Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients. A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. They were further divided into a training cohort and a validation cohort. The Akaike information criterion was used to select variables for the nomogram. The discrimination and calibration of the nomogram were evaluated using concordance index (C-index), area under time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration plots. The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics (FIGO) criteria-based tumor staging using decision curve analysis (DCA). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were also used to compare the nomogram's clinical utility with that of the FIGO criteria-based tumor staging. The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared. Seven variables were selected to establish the nomogram for LG-ESS. The C-index (0.814 for the training cohort and 0.837 for the validation cohort) and the time-dependent AUC (> 0.7) indicated satisfactory discriminative ability of the nomogram. The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts. The NRI values (training cohort: 0.271 for 5-year and 0.433 for 10-year OS prediction; validation cohort: 0.310 for 5-year and 0.383 for 10-year OS prediction) and IDI (training cohort: 0.146 for 5-year and 0.185 for 10-year OS prediction; validation cohort: 0.177 for 5-year and 0.191 for 10-year OS prediction) indicated that the established nomogram performed significantly better than the FIGO criteria-based tumor staging alone (P < 0.05). Furthermore, DCA showed that the nomogram was clinically useful and had better discriminative ability to recognize patients at high risk than the FIGO criteria-based tumor staging. A prognostic nomogram was developed and validated to assist clinicians in evaluating prognosis of LG-ESS patients.
Sections du résumé
BACKGROUND
Low-grade endometrial stromal sarcoma (LG-ESS) is a rare tumor that lacks a prognostic prediction model. Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.
METHODS
A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. They were further divided into a training cohort and a validation cohort. The Akaike information criterion was used to select variables for the nomogram. The discrimination and calibration of the nomogram were evaluated using concordance index (C-index), area under time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration plots. The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics (FIGO) criteria-based tumor staging using decision curve analysis (DCA). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were also used to compare the nomogram's clinical utility with that of the FIGO criteria-based tumor staging. The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.
RESULTS
Seven variables were selected to establish the nomogram for LG-ESS. The C-index (0.814 for the training cohort and 0.837 for the validation cohort) and the time-dependent AUC (> 0.7) indicated satisfactory discriminative ability of the nomogram. The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts. The NRI values (training cohort: 0.271 for 5-year and 0.433 for 10-year OS prediction; validation cohort: 0.310 for 5-year and 0.383 for 10-year OS prediction) and IDI (training cohort: 0.146 for 5-year and 0.185 for 10-year OS prediction; validation cohort: 0.177 for 5-year and 0.191 for 10-year OS prediction) indicated that the established nomogram performed significantly better than the FIGO criteria-based tumor staging alone (P < 0.05). Furthermore, DCA showed that the nomogram was clinically useful and had better discriminative ability to recognize patients at high risk than the FIGO criteria-based tumor staging.
CONCLUSIONS
A prognostic nomogram was developed and validated to assist clinicians in evaluating prognosis of LG-ESS patients.
Identifiants
pubmed: 32558385
doi: 10.1002/cac2.12067
pmc: PMC7365459
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
301-312Informations de copyright
© 2020 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.
Références
Int J Surg. 2015 Nov;23(Pt A):147-51
pubmed: 26449652
Lancet Oncol. 2015 Apr;16(4):e173-80
pubmed: 25846097
Cancer. 1966 Jun;19(6):755-66
pubmed: 5939046
Cancer Commun (Lond). 2019 Oct 11;39(1):55
pubmed: 31601270
Can J Gastroenterol. 2008 Oct;22(10):835-9
pubmed: 18925308
Br J Cancer. 2008 Oct 21;99(8):1210-5
pubmed: 18813312
Gynecol Oncol. 2017 Aug;146(2):254-262
pubmed: 28596015
Cancer Commun (Lond). 2019 Nov 27;39(1):80
pubmed: 31775884
Geburtshilfe Frauenheilkd. 2015 Oct;75(10):1028-1042
pubmed: 26640293
Clin Cancer Res. 2004 Nov 1;10(21):7252-9
pubmed: 15534099
Int J Gynecol Cancer. 2009 Oct;19(7):1232-8
pubmed: 19823060
Gynecol Oncol. 2010 Jul;118(1):8-13
pubmed: 20447684
JAMA. 2015 Jan 27;313(4):409-10
pubmed: 25626037
Stat Med. 2011 Jan 15;30(1):11-21
pubmed: 21204120
Adv Anat Pathol. 2014 Nov;21(6):383-93
pubmed: 25299308
Int J Gynecol Cancer. 2009 Aug;19(6):1080-4
pubmed: 19820372
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):728-34
pubmed: 19700247
J Cancer. 2018 Oct 10;9(21):3923-3928
pubmed: 30410596
Stat Med. 2013 Jun 30;32(14):2430-42
pubmed: 23037800
BMC Cancer. 2017 Jan 31;17(1):91
pubmed: 28143427
Int J Gynecol Cancer. 2016 Jul;26(6):1098-104
pubmed: 27177280
Cancer Manag Res. 2019 Jan 17;11:831-837
pubmed: 30697075
BMJ. 2015 Jan 07;350:g7594
pubmed: 25569120
Clin Transl Oncol. 2010 Mar;12(3):226-30
pubmed: 20231128
Obstet Gynecol. 2013 Sep;122(3):676-83
pubmed: 23921879
Gynecol Oncol. 2014 Jan;132(1):70-5
pubmed: 24184602
J Clin Pathol. 2015 May;68(5):325-32
pubmed: 25595274
Med Decis Making. 2006 Nov-Dec;26(6):565-74
pubmed: 17099194
Gynecol Oncol. 2014 Mar;132(3):654-60
pubmed: 24412112
Ann Oncol. 2010 Oct;21(10):2102-6
pubmed: 20305035
Cancer Commun (Lond). 2020 Jul;40(7):301-312
pubmed: 32558385
J Gastrointest Oncol. 2018 Feb;9(1):52-63
pubmed: 29564171
Gynecol Oncol. 2005 Feb;96(2):402-6
pubmed: 15661228
Oncol Res Treat. 2018;41(11):687-692
pubmed: 30317238
Surg Oncol Clin N Am. 2018 Apr;27(2):401-412
pubmed: 29496097
Gynecol Oncol. 2017 Mar;144(3):524-530
pubmed: 28109626
Cancer Manag Res. 2018 Feb 05;10:227-238
pubmed: 29440932
J Bone Oncol. 2018 Oct 04;13:106-113
pubmed: 30591864
Obstet Gynecol. 2008 Nov;112(5):1102-8
pubmed: 18978112
Oncol Lett. 2019 Oct;18(4):3591-3598
pubmed: 31516573
Cancer Res. 1990 Mar 15;50(6):1886-9
pubmed: 2306740
Acta Oncol. 2012 Jul;51(6):694-705
pubmed: 22793037