Jun Zhang1,2,3, Zhenyu Pan1,2,4, Fanfan Zhao1,2, Xiaojie Feng1,2, Yuanchi Huang3, Chuanyu Hu5, Yuanjie Li6, Jun Lyu7,8,9. 1. Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. 2. School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. 3. Department of Orthopaedics, Baoji Municipal Central Hospital, Baoji, Shaanxi, China. 4. Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. 5. Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. 6. Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. liyj2010@xjtu.edu.cn. 7. Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. lujun2006@xjtu.edu.cn. 8. School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. lujun2006@xjtu.edu.cn. 9. Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China. lujun2006@xjtu.edu.cn.
Abstract
BACKGROUND: We aimed to develop and validate a reliable nomogram for predicting the disease-specific survival (DSS) of chondrosarcoma patients. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2004 to 2015 to identify cases of histologically confirmed chondrosarcoma. Multivariate Cox regression analysis was performed to identify independent prognostic factors and construct a nomogram for predicting the 3- and 5-year DSS rates. Predictive values were compared between the new model and the American Joint Committee on Cancer (AJCC) staging system using concordance indexes (C-indexes), calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). RESULTS: Multivariate Cox regression identified 1180 patients, who were used to establish a nomogram based on a new model containing the predictive variables of age, socioeconomic status, tumor size, surgery status, chemotherapy status, and AJCC staging. In the nomogram, age at diagnosis is the factor with the highest risk, followed by AJCC stage IV and tumor size > 100 mm. Both the C-index and the calibration plots demonstrated the good performance of the nomogram. Moreover, both NRI and IDI were improved compared to the AJCC staging system, and also DCA demonstrated that the nomogram is clinically useful. CONCLUSION: We have developed a reliable nomogram for determining the prognosis and treatment outcomes of chondrosarcoma patients that is superior to the traditional AJCC staging system.
BACKGROUND: We aimed to develop and validate a reliable nomogram for predicting the disease-specific survival (DSS) of chondrosarcomapatients. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2004 to 2015 to identify cases of histologically confirmed chondrosarcoma. Multivariate Cox regression analysis was performed to identify independent prognostic factors and construct a nomogram for predicting the 3- and 5-year DSS rates. Predictive values were compared between the new model and the American Joint Committee on Cancer (AJCC) staging system using concordance indexes (C-indexes), calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). RESULTS: Multivariate Cox regression identified 1180 patients, who were used to establish a nomogram based on a new model containing the predictive variables of age, socioeconomic status, tumor size, surgery status, chemotherapy status, and AJCC staging. In the nomogram, age at diagnosis is the factor with the highest risk, followed by AJCC stage IV and tumor size > 100 mm. Both the C-index and the calibration plots demonstrated the good performance of the nomogram. Moreover, both NRI and IDI were improved compared to the AJCC staging system, and also DCA demonstrated that the nomogram is clinically useful. CONCLUSION: We have developed a reliable nomogram for determining the prognosis and treatment outcomes of chondrosarcomapatients that is superior to the traditional AJCC staging system.
Authors: Elena Nemecek; Philipp Theodor Funovics; Gerhard Martin Hobusch; Susanna Lang; Madeleine Willegger; Florian Sevelda; Thomas Brodowicz; Christoph Stihsen; Reinhard Windhager; Joannis Panotopoulos Journal: J Orthop Res Date: 2018-05-24 Impact factor: 3.494