Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study
Backgrounds Adenocarcinoma of the bladder (ACB) rarely occurs but is associated with poor outcome. We aim to establish reliable nomograms for estimating cancer-specific survival (CSS) and overall survival (OS) of ACB patients. Methods ACB patients were retrieved from the Surveillance, Epidemiology,...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-01-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | http://dx.doi.org/10.1080/08941939.2020.1812776 |
| _version_ | 1797684537716637696 |
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| author | Zhiqiang Yang Yunjin Bai Maoying Liu Xu Hu Ping Han |
| author_facet | Zhiqiang Yang Yunjin Bai Maoying Liu Xu Hu Ping Han |
| author_sort | Zhiqiang Yang |
| collection | DOAJ |
| description | Backgrounds Adenocarcinoma of the bladder (ACB) rarely occurs but is associated with poor outcome. We aim to establish reliable nomograms for estimating cancer-specific survival (CSS) and overall survival (OS) of ACB patients. Methods ACB patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015). A total of 1,149 patients were randomly divided into training cohort (n = 692) and validation cohort (n = 457). Multivariate Cox proportional hazards regression models were employed to identify independent prognostic factors. Nomograms predicting OS and CSS were constructed utilizing screened factors. The performance of nomograms was internally and externally validated by calibration curves, the receiver operating characteristic (ROC) curves, concordance index (C-index), and decision curve analysis (DCA). Results OS nomogram incorporated age, race, histologic grade, American Joint Committee of Cancer (AJCC) stage, metastasis, surgery, chemotherapy, and tumor size. The C-indices were 0.754 (95% CI: 0.732–0.775) for training set and 0.743 (95% CI: 0.712–0.767) for validation set. Meanwhile, the calibration plots for 3- and 5-year OS displayed fine concordance between actual and predicted outcomes. In addition, higher areas under the curve (AUCs) were seen in training cohort (3-year: 0.799 vs. 0.630; 5-year: 0.797 vs. 0.648) and validation cohort (3-year: 0.802 vs. 0.662; 5-year: 0.752 vs. 0.660). Finally, DCA curves of the nomograms exhibited larger net benefits than AJCC stage. CSS nomogram showed similar results. Conclusion Our study constructed and validated nomograms with improved discriminative abilities and clinical benefits to predict the survival outcomes of ACB patients. The models might assist clinicians in optimizing therapeutic management on individual levels. |
| first_indexed | 2024-03-12T00:31:09Z |
| format | Article |
| id | doaj.art-5991df08037d4616b51216b53dc855ef |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:31:09Z |
| publishDate | 2022-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-5991df08037d4616b51216b53dc855ef2023-09-15T10:21:26ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-01-01351303710.1080/08941939.2020.18127761812776Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based StudyZhiqiang Yang0Yunjin Bai1Maoying Liu2Xu Hu3Ping Han4Department of Urology, West China Hospital, Sichuan UniversityDepartment of Urology, West China Hospital, Sichuan UniversityAnyue Hengkang HospitalWest China School of Medicine/West China Hospital, Sichuan UniversityDepartment of Urology, West China Hospital, Sichuan UniversityBackgrounds Adenocarcinoma of the bladder (ACB) rarely occurs but is associated with poor outcome. We aim to establish reliable nomograms for estimating cancer-specific survival (CSS) and overall survival (OS) of ACB patients. Methods ACB patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015). A total of 1,149 patients were randomly divided into training cohort (n = 692) and validation cohort (n = 457). Multivariate Cox proportional hazards regression models were employed to identify independent prognostic factors. Nomograms predicting OS and CSS were constructed utilizing screened factors. The performance of nomograms was internally and externally validated by calibration curves, the receiver operating characteristic (ROC) curves, concordance index (C-index), and decision curve analysis (DCA). Results OS nomogram incorporated age, race, histologic grade, American Joint Committee of Cancer (AJCC) stage, metastasis, surgery, chemotherapy, and tumor size. The C-indices were 0.754 (95% CI: 0.732–0.775) for training set and 0.743 (95% CI: 0.712–0.767) for validation set. Meanwhile, the calibration plots for 3- and 5-year OS displayed fine concordance between actual and predicted outcomes. In addition, higher areas under the curve (AUCs) were seen in training cohort (3-year: 0.799 vs. 0.630; 5-year: 0.797 vs. 0.648) and validation cohort (3-year: 0.802 vs. 0.662; 5-year: 0.752 vs. 0.660). Finally, DCA curves of the nomograms exhibited larger net benefits than AJCC stage. CSS nomogram showed similar results. Conclusion Our study constructed and validated nomograms with improved discriminative abilities and clinical benefits to predict the survival outcomes of ACB patients. The models might assist clinicians in optimizing therapeutic management on individual levels.http://dx.doi.org/10.1080/08941939.2020.1812776adenocarcinomabladder cancerprognosisnomogramsurvival analysis |
| spellingShingle | Zhiqiang Yang Yunjin Bai Maoying Liu Xu Hu Ping Han Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study Journal of Investigative Surgery adenocarcinoma bladder cancer prognosis nomogram survival analysis |
| title | Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study |
| title_full | Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study |
| title_fullStr | Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study |
| title_full_unstemmed | Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study |
| title_short | Development and Validation of Prognostic Nomograms to Predict Overall and Cancer-Specific Survival for Patients with Adenocarcinoma of the Urinary Bladder: A Population-Based Study |
| title_sort | development and validation of prognostic nomograms to predict overall and cancer specific survival for patients with adenocarcinoma of the urinary bladder a population based study |
| topic | adenocarcinoma bladder cancer prognosis nomogram survival analysis |
| url | http://dx.doi.org/10.1080/08941939.2020.1812776 |
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