Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database
ObjectiveTo explore the risk factors for survival and prognosis of patients with metastatic endometrial cancer and to build and verify a reliable prediction model.MethodsWe retrospectively analyzed patients diagnosed with metastatic endometrial cancer in the US Surveillance, Epidemiology, and End Re...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1001791/full |
| _version_ | 1797959973201772544 |
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| author | Meng Zhang Ruiping Li Shan Zhang Xin Xu Lixin Liao Yan Yang Yuzhen Guo |
| author_facet | Meng Zhang Ruiping Li Shan Zhang Xin Xu Lixin Liao Yan Yang Yuzhen Guo |
| author_sort | Meng Zhang |
| collection | DOAJ |
| description | ObjectiveTo explore the risk factors for survival and prognosis of patients with metastatic endometrial cancer and to build and verify a reliable prediction model.MethodsWe retrospectively analyzed patients diagnosed with metastatic endometrial cancer in the US Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015. Univariate and multivariate Cox regression analyses were used to assess clinical variables impact on survival and to construct nomograms. The results of the consistency index (C-index), subject operating characteristic (ROC) curve, and calibration curve were used to evaluate the predictive ability of the nomogram.ResultsThis study included 3,878 patients with metastatic endometrial cancer. In the univariate analysis, variables associated with overall survival (OS) and cancer-specific survival (CSS) included age, race, marital status, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, bone metastasis, brain metastasis, liver metastasis, and lung metastasis. In the multivariate analysis, age, race, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, and lung metastasis were independent risk factors for OS and CSS (all P < 0.05). Combined with the results of the multiple factors, the 1-, 3-, 5-, and 8-year nomograms were constructed. For OS and CSS, T-stage had the greatest impact on the adverse prognosis of patients with metastatic endometrial cancer. The C-indexes of the OS and CSS nomograms in the training cohort were 0.749 (95% CI, 0.739–0.760) and 0.746 (95% CI, 0.736–0.756), respectively. The C-indices of OS and CSS in the validation cohort were 0.730 (95% CI, 0.714–0.746) and 0.728 (95% CI, 0.712–0.744), respectively. The ROC curve revealed our model's good prediction accuracy and clinical practicability. The calibration curve also confirmed the consistency between the model and actual existence. The Kaplan-Meier curves revealed statistically significant differences between the risk subgroups (P < 0.05).ConclusionOur SEER-based nomograms for predicting survival in patients with metastatic endometrial cancer were helpful for the clinical evaluation of patient prognosis. |
| first_indexed | 2024-04-11T00:39:17Z |
| format | Article |
| id | doaj.art-89ff9da41631418a9f8adb3e4ad34c01 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:39:17Z |
| publishDate | 2023-01-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-89ff9da41631418a9f8adb3e4ad34c012023-01-06T09:38:09ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10017911001791Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results databaseMeng ZhangRuiping LiShan ZhangXin XuLixin LiaoYan YangYuzhen GuoObjectiveTo explore the risk factors for survival and prognosis of patients with metastatic endometrial cancer and to build and verify a reliable prediction model.MethodsWe retrospectively analyzed patients diagnosed with metastatic endometrial cancer in the US Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015. Univariate and multivariate Cox regression analyses were used to assess clinical variables impact on survival and to construct nomograms. The results of the consistency index (C-index), subject operating characteristic (ROC) curve, and calibration curve were used to evaluate the predictive ability of the nomogram.ResultsThis study included 3,878 patients with metastatic endometrial cancer. In the univariate analysis, variables associated with overall survival (OS) and cancer-specific survival (CSS) included age, race, marital status, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, bone metastasis, brain metastasis, liver metastasis, and lung metastasis. In the multivariate analysis, age, race, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, and lung metastasis were independent risk factors for OS and CSS (all P < 0.05). Combined with the results of the multiple factors, the 1-, 3-, 5-, and 8-year nomograms were constructed. For OS and CSS, T-stage had the greatest impact on the adverse prognosis of patients with metastatic endometrial cancer. The C-indexes of the OS and CSS nomograms in the training cohort were 0.749 (95% CI, 0.739–0.760) and 0.746 (95% CI, 0.736–0.756), respectively. The C-indices of OS and CSS in the validation cohort were 0.730 (95% CI, 0.714–0.746) and 0.728 (95% CI, 0.712–0.744), respectively. The ROC curve revealed our model's good prediction accuracy and clinical practicability. The calibration curve also confirmed the consistency between the model and actual existence. The Kaplan-Meier curves revealed statistically significant differences between the risk subgroups (P < 0.05).ConclusionOur SEER-based nomograms for predicting survival in patients with metastatic endometrial cancer were helpful for the clinical evaluation of patient prognosis.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1001791/fullendometrial cancermetastasisSEER databasenomogrampredictive model fund program: natural science foundation of gansu province(17JR5RA242) |
| spellingShingle | Meng Zhang Ruiping Li Shan Zhang Xin Xu Lixin Liao Yan Yang Yuzhen Guo Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database Frontiers in Surgery endometrial cancer metastasis SEER database nomogram predictive model fund program: natural science foundation of gansu province(17JR5RA242) |
| title | Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database |
| title_full | Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database |
| title_fullStr | Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database |
| title_full_unstemmed | Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database |
| title_short | Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database |
| title_sort | analysis of prognostic factors of metastatic endometrial cancer based on surveillance epidemiology and end results database |
| topic | endometrial cancer metastasis SEER database nomogram predictive model fund program: natural science foundation of gansu province(17JR5RA242) |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1001791/full |
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