Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study
Abstract Background This study is to determine the risk factors for metastasis of Ewing sarcoma (ES) patients in SEER database. Then explore clinicopathological factors associated with poor prognosis. Furthermore, develop the nomogram to predict the probability of overall survival and cancer-specifi...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-03-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01607-8 |
| _version_ | 1828136272591323136 |
|---|---|
| author | Jiaqi Shi Jianing Yang Xin Ma Xu Wang |
| author_facet | Jiaqi Shi Jianing Yang Xin Ma Xu Wang |
| author_sort | Jiaqi Shi |
| collection | DOAJ |
| description | Abstract Background This study is to determine the risk factors for metastasis of Ewing sarcoma (ES) patients in SEER database. Then explore clinicopathological factors associated with poor prognosis. Furthermore, develop the nomogram to predict the probability of overall survival and cancer-specific survival Methods Thus, we collected clinicopathological data of ES patients in SEER database, and then used chi-square test and logistic regression to determine risk factors associated to metastasis. We also did survival analysis including Kaplan-Meier curve and Cox proportional hazard model to explore the risk factors associated to overall survival and cancer-specific survival, and then developed the nomogram to visualize and quantify the probability of survival. Results After statistics, we find that patients with older ages (11–20 years old: OR = 1.517, 95% confidence interval [CI] 1.033–2.228, p = 0.034; 21–30 years old: OR = 1.659. 95%CI 1.054–2.610, p = 0.029), larger tumor size (> 8 cm: OR = 1.914, 95%CI 1.251–2.928, p = 0.003), and pelvic lesions (OR = 2.492, 95%CI 1.829–3.395, p < 0.001) had a higher risk of metastasis. ROC curves showed higher AUC (0.65) of combined model which incorporate these three factors to predict the presence of metastasis at diagnosis. In survival analysis, patients with older ages (11–20 years: HR = 1.549, 95%CI 1.144–2.099, p = 0.005; 21–30 years: HR = 1.808, 95%CI 1.278–2.556, p = 0.001; 31–49 years: HR = 3.481, 95%CI 2.379–5.094, p < 0.001; ≥ 50 years: HR = 4.307, 95%CI 2.648–7.006, p < 0.001) , larger tumor size (5–8 cm: HR = 1.386, 95%CI 1.005–1.991, p = 0.046; > 8 cm: HR = 1.877, 95%CI 1.376–2.561, p < 0.001), black race (HR = 2.104, 95%CI 1.296–3.416, p = 0.003), and wider extension (regional: HR = 1.373, 95%CI 1.033–1.823, p = 0.029; metastatic: HR = 3.259, 95%CI 2.425–4.379, p < 0.001) were associated with worse prognosis. Chemotherapy was associated with better prognosis (HR = 0.466, 95%CI 0.290–0.685, p < 0.001). The nomogram which developed by training set and aimed to predict OS and CSS showed good consistency with actual observed outcomes internally and externally. Conclusion In conclusion, tumor size and primary site were associated with distant metastasis at diagnosis. Age, tumor size, primary site, tumor extent, and chemotherapy were associated with overall survival and cancer-specific survival. Nomogram could predict the probability of OS and CSS and showed good consistency with actual observed outcomes internally and externally. |
| first_indexed | 2024-04-11T18:00:40Z |
| format | Article |
| id | doaj.art-2cd78e1e6f9f4d4d975e2b93c5f2d2d5 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T18:00:40Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-2cd78e1e6f9f4d4d975e2b93c5f2d2d52022-12-22T04:10:29ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-03-0115111410.1186/s13018-020-01607-8Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based studyJiaqi Shi0Jianing Yang1Xin Ma2Xu Wang3Department of Orthopedics, Huashan Hospital, Fudan UniversityDepartment of Radiotherapy, Oncology Hospital, Fudan UniversityDepartment of Orthopedics, Huashan Hospital, Fudan UniversityDepartment of Orthopedics, Huashan Hospital, Fudan UniversityAbstract Background This study is to determine the risk factors for metastasis of Ewing sarcoma (ES) patients in SEER database. Then explore clinicopathological factors associated with poor prognosis. Furthermore, develop the nomogram to predict the probability of overall survival and cancer-specific survival Methods Thus, we collected clinicopathological data of ES patients in SEER database, and then used chi-square test and logistic regression to determine risk factors associated to metastasis. We also did survival analysis including Kaplan-Meier curve and Cox proportional hazard model to explore the risk factors associated to overall survival and cancer-specific survival, and then developed the nomogram to visualize and quantify the probability of survival. Results After statistics, we find that patients with older ages (11–20 years old: OR = 1.517, 95% confidence interval [CI] 1.033–2.228, p = 0.034; 21–30 years old: OR = 1.659. 95%CI 1.054–2.610, p = 0.029), larger tumor size (> 8 cm: OR = 1.914, 95%CI 1.251–2.928, p = 0.003), and pelvic lesions (OR = 2.492, 95%CI 1.829–3.395, p < 0.001) had a higher risk of metastasis. ROC curves showed higher AUC (0.65) of combined model which incorporate these three factors to predict the presence of metastasis at diagnosis. In survival analysis, patients with older ages (11–20 years: HR = 1.549, 95%CI 1.144–2.099, p = 0.005; 21–30 years: HR = 1.808, 95%CI 1.278–2.556, p = 0.001; 31–49 years: HR = 3.481, 95%CI 2.379–5.094, p < 0.001; ≥ 50 years: HR = 4.307, 95%CI 2.648–7.006, p < 0.001) , larger tumor size (5–8 cm: HR = 1.386, 95%CI 1.005–1.991, p = 0.046; > 8 cm: HR = 1.877, 95%CI 1.376–2.561, p < 0.001), black race (HR = 2.104, 95%CI 1.296–3.416, p = 0.003), and wider extension (regional: HR = 1.373, 95%CI 1.033–1.823, p = 0.029; metastatic: HR = 3.259, 95%CI 2.425–4.379, p < 0.001) were associated with worse prognosis. Chemotherapy was associated with better prognosis (HR = 0.466, 95%CI 0.290–0.685, p < 0.001). The nomogram which developed by training set and aimed to predict OS and CSS showed good consistency with actual observed outcomes internally and externally. Conclusion In conclusion, tumor size and primary site were associated with distant metastasis at diagnosis. Age, tumor size, primary site, tumor extent, and chemotherapy were associated with overall survival and cancer-specific survival. Nomogram could predict the probability of OS and CSS and showed good consistency with actual observed outcomes internally and externally.http://link.springer.com/article/10.1186/s13018-020-01607-8Ewing sarcomaMetastasisNomogramsPrognosisRisk factors |
| spellingShingle | Jiaqi Shi Jianing Yang Xin Ma Xu Wang Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study Journal of Orthopaedic Surgery and Research Ewing sarcoma Metastasis Nomograms Prognosis Risk factors |
| title | Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study |
| title_full | Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study |
| title_fullStr | Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study |
| title_full_unstemmed | Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study |
| title_short | Risk factors for metastasis and poor prognosis of Ewing sarcoma: a population based study |
| title_sort | risk factors for metastasis and poor prognosis of ewing sarcoma a population based study |
| topic | Ewing sarcoma Metastasis Nomograms Prognosis Risk factors |
| url | http://link.springer.com/article/10.1186/s13018-020-01607-8 |
| work_keys_str_mv | AT jiaqishi riskfactorsformetastasisandpoorprognosisofewingsarcomaapopulationbasedstudy AT jianingyang riskfactorsformetastasisandpoorprognosisofewingsarcomaapopulationbasedstudy AT xinma riskfactorsformetastasisandpoorprognosisofewingsarcomaapopulationbasedstudy AT xuwang riskfactorsformetastasisandpoorprognosisofewingsarcomaapopulationbasedstudy |