Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations
ObjectiveThis study aimed to comprehensively investigate the relationship between the survival differences and socioeconomic status (SES) in patients with multiple myeloma (MM) and construct a predictive nomogram to assess clinical outcomes of MM patients.MethodsThe Surveillance, Epidemiology, and E...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.941714/full |
| _version_ | 1817998068049510400 |
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| author | Jiaxuan Xu Peipei Xu Qiaoyan Han Qiaoyan Han Jingjing Sun Bing Chen Xiaoqing Dong |
| author_facet | Jiaxuan Xu Peipei Xu Qiaoyan Han Qiaoyan Han Jingjing Sun Bing Chen Xiaoqing Dong |
| author_sort | Jiaxuan Xu |
| collection | DOAJ |
| description | ObjectiveThis study aimed to comprehensively investigate the relationship between the survival differences and socioeconomic status (SES) in patients with multiple myeloma (MM) and construct a predictive nomogram to assess clinical outcomes of MM patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) census tract-level SES database provides two specialized attributes: SES index and rurality. Using this database, 37,819 patients diagnosed with MM between January 2007 and December 2016 were enrolled. We evaluated the effects of SES index on overall survival (OS) and myeloma-specific survival (MSS) using Kaplan-Meier curves and Cox regression analyses. Thereafter, we included 126 patients with MM from two independent medical centers in China and divided them into training (Center 1) and validation (Center 2) cohorts. Univariate and multivariate Cox analyses were used in the training cohort to construct a nomogram for predicting clinical outcomes. Nomogram performance was assessed using the area under the curve (AUC) and calibration curves.ResultsIn the SEER cohort, lower SES was significantly associated with worse OS rates and MSS rates (both P < 0.001). Multivariate analysis confirmed SES as an independent predictor of survival. Subgroup analysis indicated an increasing linear trend in survival benefits in non-Hispanic White, married, insured, and urban populations with increasing SES (all P < 0.001). In the training cohort, albumin, creatinine, rurality, and SES were confirmed as independent prognostic indicators. A nomogram for OS prediction was developed using these four factors, and it showed satisfactory discrimination and calibration. The 18- and 36-month AUC values of the nomogram were 0.79 and 0.82, respectively. Based on the total nomogram points, patients were categorized into two risk levels with good separation.ConclusionSES strongly influences survival disparities in patients with MM. Our nomogram consisting of clinical and sociodemographic characteristics can potentially predict survival outcomes. |
| first_indexed | 2024-04-14T02:47:40Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T02:47:40Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-218aea79eb184f469de0b8c4d82f00232022-12-22T02:16:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.941714941714Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populationsJiaxuan Xu0Peipei Xu1Qiaoyan Han2Qiaoyan Han3Jingjing Sun4Bing Chen5Xiaoqing Dong6Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Hematology, Jingjiang People’s Hospital, Jingjiang, ChinaDepartment of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, ChinaObjectiveThis study aimed to comprehensively investigate the relationship between the survival differences and socioeconomic status (SES) in patients with multiple myeloma (MM) and construct a predictive nomogram to assess clinical outcomes of MM patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) census tract-level SES database provides two specialized attributes: SES index and rurality. Using this database, 37,819 patients diagnosed with MM between January 2007 and December 2016 were enrolled. We evaluated the effects of SES index on overall survival (OS) and myeloma-specific survival (MSS) using Kaplan-Meier curves and Cox regression analyses. Thereafter, we included 126 patients with MM from two independent medical centers in China and divided them into training (Center 1) and validation (Center 2) cohorts. Univariate and multivariate Cox analyses were used in the training cohort to construct a nomogram for predicting clinical outcomes. Nomogram performance was assessed using the area under the curve (AUC) and calibration curves.ResultsIn the SEER cohort, lower SES was significantly associated with worse OS rates and MSS rates (both P < 0.001). Multivariate analysis confirmed SES as an independent predictor of survival. Subgroup analysis indicated an increasing linear trend in survival benefits in non-Hispanic White, married, insured, and urban populations with increasing SES (all P < 0.001). In the training cohort, albumin, creatinine, rurality, and SES were confirmed as independent prognostic indicators. A nomogram for OS prediction was developed using these four factors, and it showed satisfactory discrimination and calibration. The 18- and 36-month AUC values of the nomogram were 0.79 and 0.82, respectively. Based on the total nomogram points, patients were categorized into two risk levels with good separation.ConclusionSES strongly influences survival disparities in patients with MM. Our nomogram consisting of clinical and sociodemographic characteristics can potentially predict survival outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2022.941714/fullSESmultiple myelomanomogramrisk stratificationmyeloma-specific survival |
| spellingShingle | Jiaxuan Xu Peipei Xu Qiaoyan Han Qiaoyan Han Jingjing Sun Bing Chen Xiaoqing Dong Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations Frontiers in Oncology SES multiple myeloma nomogram risk stratification myeloma-specific survival |
| title | Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations |
| title_full | Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations |
| title_fullStr | Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations |
| title_full_unstemmed | Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations |
| title_short | Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations |
| title_sort | socioeconomic status based survival disparities and nomogram prediction for patients with multiple myeloma results from american and chinese populations |
| topic | SES multiple myeloma nomogram risk stratification myeloma-specific survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.941714/full |
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