Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation
Abstract Purpose This study aimed to compare the prognostic value of multiple lymph node metastasis (LNM) indicators and to develop optimal prognostic nomograms for bladder cancer (BC) patients. Methods BC patients were obtained from the Surveillance, Epidemiology, and End Results (SEER) database be...
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5475 |
| _version_ | 1797854209937244160 |
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| author | Shuai Li Yicun Wang Xiaopeng Hu |
| author_facet | Shuai Li Yicun Wang Xiaopeng Hu |
| author_sort | Shuai Li |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to compare the prognostic value of multiple lymph node metastasis (LNM) indicators and to develop optimal prognostic nomograms for bladder cancer (BC) patients. Methods BC patients were obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015, and randomly partitioned into training and internal validation cohorts. Genomic and clinical data were collected from The Cancer Genome Atlas (TCGA) as external validation cohort. The predictive efficiency of LNM indicators was compared by constructing multivariate Cox regression models. We constructed nomograms on basis of the optimal models selected for overall survival (OS) and cause‐specific survival (CSS). The performance of nomograms was evaluated with calibration plot, time‐dependent area under the curve (AUC) and decision curve analysis (DCA) in three cohorts. We subsequently estimated the difference of biological function and tumor immunity between two risk groups stratified by nomograms in TCGA cohort. Results Totally, 10,093 and 107 BC patients were screened from the SEER and TCGA databases. N classification, positive lymph nodes (PLNs), lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) were all independent predictors for OS and CSS. The filtered models containing LODDS had minimal Akaike Information Criterion, maximal concordance indexes and AUCs. Age, LODDS, T and M classification were integrated into nomogram for OS, while nomogram for CSS included gender, tumor grade, LODDS, T and M classification. The nomograms were successfully validated in predictive accuracy and clinical utility in three cohorts. Additionally, the tumor microenvironment was different between two risk groups. Conclusions LODDS demonstrated superior prognostic performance over N classification, PLN and LNR for OS and CSS of BC patients. The nomograms incorporating LODDS provided appropriate prediction of BC, which could contribute to the tumor assessment and clinical decision‐making. |
| first_indexed | 2024-04-09T20:02:54Z |
| format | Article |
| id | doaj.art-8971cba546794ea79b75e51c86cac6eb |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T20:02:54Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-8971cba546794ea79b75e51c86cac6eb2023-04-02T20:55:00ZengWileyCancer Medicine2045-76342023-03-011266853686610.1002/cam4.5475Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validationShuai Li0Yicun Wang1Xiaopeng Hu2Department of Urology Beijing Chao‐Yang Hospital, Capital Medical University Beijing ChinaDepartment of Urology Beijing Chao‐Yang Hospital, Capital Medical University Beijing ChinaDepartment of Urology Beijing Chao‐Yang Hospital, Capital Medical University Beijing ChinaAbstract Purpose This study aimed to compare the prognostic value of multiple lymph node metastasis (LNM) indicators and to develop optimal prognostic nomograms for bladder cancer (BC) patients. Methods BC patients were obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015, and randomly partitioned into training and internal validation cohorts. Genomic and clinical data were collected from The Cancer Genome Atlas (TCGA) as external validation cohort. The predictive efficiency of LNM indicators was compared by constructing multivariate Cox regression models. We constructed nomograms on basis of the optimal models selected for overall survival (OS) and cause‐specific survival (CSS). The performance of nomograms was evaluated with calibration plot, time‐dependent area under the curve (AUC) and decision curve analysis (DCA) in three cohorts. We subsequently estimated the difference of biological function and tumor immunity between two risk groups stratified by nomograms in TCGA cohort. Results Totally, 10,093 and 107 BC patients were screened from the SEER and TCGA databases. N classification, positive lymph nodes (PLNs), lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) were all independent predictors for OS and CSS. The filtered models containing LODDS had minimal Akaike Information Criterion, maximal concordance indexes and AUCs. Age, LODDS, T and M classification were integrated into nomogram for OS, while nomogram for CSS included gender, tumor grade, LODDS, T and M classification. The nomograms were successfully validated in predictive accuracy and clinical utility in three cohorts. Additionally, the tumor microenvironment was different between two risk groups. Conclusions LODDS demonstrated superior prognostic performance over N classification, PLN and LNR for OS and CSS of BC patients. The nomograms incorporating LODDS provided appropriate prediction of BC, which could contribute to the tumor assessment and clinical decision‐making.https://doi.org/10.1002/cam4.5475bladder cancerLODDSlymph node metastasisnomogramprognosisSEER |
| spellingShingle | Shuai Li Yicun Wang Xiaopeng Hu Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation Cancer Medicine bladder cancer LODDS lymph node metastasis nomogram prognosis SEER |
| title | Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation |
| title_full | Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation |
| title_fullStr | Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation |
| title_full_unstemmed | Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation |
| title_short | Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population‐based study and external validation |
| title_sort | prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer a seer population based study and external validation |
| topic | bladder cancer LODDS lymph node metastasis nomogram prognosis SEER |
| url | https://doi.org/10.1002/cam4.5475 |
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