Nomogram Predicts Risk and Prognostic Factors for Bone Metastasis of Pancreatic Cancer: A Population-Based Analysis.

Cox regression Surveillance Epidemiology and End Results (SEER) database bone metastasis logistic regression nomogram pancreatic cancer predictors

Journal

Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782

Informations de publication

Date de publication:
2021
Historique:
received: 25 08 2021
accepted: 30 12 2021
entrez: 31 3 2022
pubmed: 1 4 2022
medline: 2 4 2022
Statut: epublish

Résumé

The overall survival (OS) of pancreatic cancer (PC) patients with bone metastasis (BM) is extremely low, and it is pretty hard to treat bone metastasis. However, there are currently no effective nomograms to predict the diagnosis and prognosis of pancreatic cancer with bone metastasis (PCBM). Therefore, it is of great significance to establish effective predictive models to guide clinical practice. We screened patients from Surveillance Epidemiology and End Results (SEER) database between 2010 and 2016. The independent risk factors of PCBM were identified from univariable and multivariable logistic regression analyses, and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors affecting the prognosis of PCBM. In addition, two nomograms were constructed to predict the risk and prognosis of PCBM. We used the area under the curve (AUC), C-index and calibration curve to determine the predictive accuracy and discriminability of nomograms. The decision curve analysis (DCA) and Kaplan-Meier(K-M) survival curves were employed to further confirm the clinical effectiveness of the nomogram. Multivariable logistic regression analyses revealed that risk factors of PCBM included age, primary site, histological subtype, N stage, radiotherapy, surgery, brain metastasis, lung metastasis, and liver metastasis. Using Cox regression analyses, we found that independent prognostic factors of PCBM were age, race, grade, histological subtype, surgery, chemotherapy, and lung metastasis. We utilized nomograms to visually express data analysis results. The C-index of training cohort was 0.795 (95%CI: 0.758-0.832), whereas that of internal validation cohort was 0.800 (95%CI: 0.739-0.862), and the external validation cohort was 0.787 (95%CI: 0.746-0.828). Based on AUC of receiver operating characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA), we concluded that the risk and prognosis model of PCBM exhibits excellent performance. Nomogram is sufficiently accurate to predict the risk and prognostic factors of PCBM, allowing for individualized clinical decisions for future clinical work.

Sections du résumé

Background
The overall survival (OS) of pancreatic cancer (PC) patients with bone metastasis (BM) is extremely low, and it is pretty hard to treat bone metastasis. However, there are currently no effective nomograms to predict the diagnosis and prognosis of pancreatic cancer with bone metastasis (PCBM). Therefore, it is of great significance to establish effective predictive models to guide clinical practice.
Methods
We screened patients from Surveillance Epidemiology and End Results (SEER) database between 2010 and 2016. The independent risk factors of PCBM were identified from univariable and multivariable logistic regression analyses, and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors affecting the prognosis of PCBM. In addition, two nomograms were constructed to predict the risk and prognosis of PCBM. We used the area under the curve (AUC), C-index and calibration curve to determine the predictive accuracy and discriminability of nomograms. The decision curve analysis (DCA) and Kaplan-Meier(K-M) survival curves were employed to further confirm the clinical effectiveness of the nomogram.
Results
Multivariable logistic regression analyses revealed that risk factors of PCBM included age, primary site, histological subtype, N stage, radiotherapy, surgery, brain metastasis, lung metastasis, and liver metastasis. Using Cox regression analyses, we found that independent prognostic factors of PCBM were age, race, grade, histological subtype, surgery, chemotherapy, and lung metastasis. We utilized nomograms to visually express data analysis results. The C-index of training cohort was 0.795 (95%CI: 0.758-0.832), whereas that of internal validation cohort was 0.800 (95%CI: 0.739-0.862), and the external validation cohort was 0.787 (95%CI: 0.746-0.828). Based on AUC of receiver operating characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA), we concluded that the risk and prognosis model of PCBM exhibits excellent performance.
Conclusion
Nomogram is sufficiently accurate to predict the risk and prognostic factors of PCBM, allowing for individualized clinical decisions for future clinical work.

Identifiants

pubmed: 35356148
doi: 10.3389/fendo.2021.752176
pmc: PMC8959409
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

752176

Informations de copyright

Copyright © 2022 Zhang, Ji, Wang, Zhu, Luo, Zhang, Tong, Feng, Kang and Bi.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Wei Zhang (W)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Qingdao University, Qingdao, China.
Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.

Lichen Ji (L)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Xijun Wang (X)

Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China.
Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, China.

Senbo Zhu (S)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Junchao Luo (J)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Yin Zhang (Y)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Graduate Department, Bengbu Medical College, Bengbu, China.

Yu Tong (Y)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Fabo Feng (F)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China.

Yao Kang (Y)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China.

Qing Bi (Q)

Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China.

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