Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation
Background: Primary pelvis and spine osteosarcoma (PSOS) is a specific type of osteosarcoma that is difficult to treat and has a poor prognosis. In recent years, the research on osteosarcoma has been increasing, but there have been few studies on PSOS; in particular, there have been a lack of analys...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2521 |
| _version_ | 1797607674296139776 |
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| author | Da Wang Fanrong Liu Binbin Li Jinhui Xu Haiyi Gong Minglei Yang Wei Wan Jian Jiao Yujie Liu Jianru Xiao |
| author_facet | Da Wang Fanrong Liu Binbin Li Jinhui Xu Haiyi Gong Minglei Yang Wei Wan Jian Jiao Yujie Liu Jianru Xiao |
| author_sort | Da Wang |
| collection | DOAJ |
| description | Background: Primary pelvis and spine osteosarcoma (PSOS) is a specific type of osteosarcoma that is difficult to treat and has a poor prognosis. In recent years, the research on osteosarcoma has been increasing, but there have been few studies on PSOS; in particular, there have been a lack of analyses with a large sample size. This study aimed to construct and validate a model to predict the overall survival (OS) of PSOS patients, as currently there are no tools available for assessing their prognosis. Methods: Data including demographic information, clinical characteristics, and follow-up information on patients with PSOS were collected from the Surveillance, Epidemiology, and End Results (SEER) database, as well as from the Spine Tumor Center of Changzheng Hospital. Variable selection was achieved through a backward procedure based on the Akaike Information Criterion (AIC). Prognostic factors were identified by univariate and multivariate Cox analysis. A nomogram was further constructed for the estimation of 1-, 3-, and 5-year OS. Calibration plots, the concordance index (C-index), and the receiver operating characteristic (ROC) were used to evaluate the prediction model. Results: In total, 83 PSOS patients and 90 PSOS patients were separately collected from the SEER database and Changzheng Hospital. In the SEER cohort, liver metastasis, lung metastasis, and chemotherapy were recognized as independent prognostic factors for OS (<i>p</i> < 0.05) and were incorporated to construct the initial nomogram. However, the initial nomogram showed poor predictive accuracy in internal and external validation. Then, we shifted our focus to the Changzheng data. Lung metastasis involving segments, Eastern Cooperative Oncology Group (ECOG) performance score, alkaline phosphatase (ALP) level, and en bloc resection were ultimately identified as independent prognostic factors for OS (<i>p</i> < 0.05) and were further incorporated to construct the current nomogram, of which the bias-corrected C-index was 0.834 (0.824–0.856). The areas under the ROC curves (AUCs) of the current nomogram regarding 1-, 3-, and 5-year OS probabilities were 0.93, 0.96, and 0.92, respectively. Conclusion: We have developed a predictive model with satisfactory performance and clinical practicability, enabling effective prediction of the OS of PSOS patients and aiding clinicians in decision-making. |
| first_indexed | 2024-03-11T05:34:08Z |
| format | Article |
| id | doaj.art-b807452c99b5429689e13a5093200ced |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:34:08Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-b807452c99b5429689e13a5093200ced2023-11-17T16:58:17ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01127252110.3390/jcm12072521Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External ValidationDa Wang0Fanrong Liu1Binbin Li2Jinhui Xu3Haiyi Gong4Minglei Yang5Wei Wan6Jian Jiao7Yujie Liu8Jianru Xiao9Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, ChinaDepartment of Pathology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaDepartment of Orthopedic Oncology, Shanghai Changzheng Hospital, Navy Military Medical University, Shanghai 200003, ChinaBackground: Primary pelvis and spine osteosarcoma (PSOS) is a specific type of osteosarcoma that is difficult to treat and has a poor prognosis. In recent years, the research on osteosarcoma has been increasing, but there have been few studies on PSOS; in particular, there have been a lack of analyses with a large sample size. This study aimed to construct and validate a model to predict the overall survival (OS) of PSOS patients, as currently there are no tools available for assessing their prognosis. Methods: Data including demographic information, clinical characteristics, and follow-up information on patients with PSOS were collected from the Surveillance, Epidemiology, and End Results (SEER) database, as well as from the Spine Tumor Center of Changzheng Hospital. Variable selection was achieved through a backward procedure based on the Akaike Information Criterion (AIC). Prognostic factors were identified by univariate and multivariate Cox analysis. A nomogram was further constructed for the estimation of 1-, 3-, and 5-year OS. Calibration plots, the concordance index (C-index), and the receiver operating characteristic (ROC) were used to evaluate the prediction model. Results: In total, 83 PSOS patients and 90 PSOS patients were separately collected from the SEER database and Changzheng Hospital. In the SEER cohort, liver metastasis, lung metastasis, and chemotherapy were recognized as independent prognostic factors for OS (<i>p</i> < 0.05) and were incorporated to construct the initial nomogram. However, the initial nomogram showed poor predictive accuracy in internal and external validation. Then, we shifted our focus to the Changzheng data. Lung metastasis involving segments, Eastern Cooperative Oncology Group (ECOG) performance score, alkaline phosphatase (ALP) level, and en bloc resection were ultimately identified as independent prognostic factors for OS (<i>p</i> < 0.05) and were further incorporated to construct the current nomogram, of which the bias-corrected C-index was 0.834 (0.824–0.856). The areas under the ROC curves (AUCs) of the current nomogram regarding 1-, 3-, and 5-year OS probabilities were 0.93, 0.96, and 0.92, respectively. Conclusion: We have developed a predictive model with satisfactory performance and clinical practicability, enabling effective prediction of the OS of PSOS patients and aiding clinicians in decision-making.https://www.mdpi.com/2077-0383/12/7/2521osteosarcomaspinepelvisoverall survivalnomogram |
| spellingShingle | Da Wang Fanrong Liu Binbin Li Jinhui Xu Haiyi Gong Minglei Yang Wei Wan Jian Jiao Yujie Liu Jianru Xiao Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation Journal of Clinical Medicine osteosarcoma spine pelvis overall survival nomogram |
| title | Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation |
| title_full | Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation |
| title_fullStr | Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation |
| title_full_unstemmed | Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation |
| title_short | Development and Validation of a Prognostic Model for Overall Survival in Patients with Primary Pelvis and Spine Osteosarcoma: A Population-Based Study and External Validation |
| title_sort | development and validation of a prognostic model for overall survival in patients with primary pelvis and spine osteosarcoma a population based study and external validation |
| topic | osteosarcoma spine pelvis overall survival nomogram |
| url | https://www.mdpi.com/2077-0383/12/7/2521 |
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