Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System
Background: Metastatic cervical cancer (mCEC) is the end stage of cervical cancer. This study aimed to establish and validate a nomogram to predict the overall survival (OS) of mCEC patients.Methods: We investigated the Surveillance, Epidemiology, and End Results (SEER) database for mCEC patients di...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2019.01106/full |
| _version_ | 1818854604133105664 |
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| author | Shilong Zhang Shilong Zhang Xin Wang Zhanming Li Zhanming Li Wenrong Wang Lishun Wang Lishun Wang |
| author_facet | Shilong Zhang Shilong Zhang Xin Wang Zhanming Li Zhanming Li Wenrong Wang Lishun Wang Lishun Wang |
| author_sort | Shilong Zhang |
| collection | DOAJ |
| description | Background: Metastatic cervical cancer (mCEC) is the end stage of cervical cancer. This study aimed to establish and validate a nomogram to predict the overall survival (OS) of mCEC patients.Methods: We investigated the Surveillance, Epidemiology, and End Results (SEER) database for mCEC patients diagnosed between 2010 and 2014. Univariate and multivariable Cox analyses was performed to select the clinically important predictors of OS when developing the nomogram. The performance of nomogram was validated with Harrell's concordance index (C-index), calibration curves, receiver operating characteristic curve (ROC), and decision curve analysis (DCA).Results: One thousand two hundred and fifty-two mCEC patients were included and were divided into training (n = 880) and independent validation (n = 372) cohorts. Age, race, pathological type, histology grade, radiotherapy, and chemotherapy were independent predictors of OS and used to develop the nomogram for predicting 1- and 3-year OS. This nomogram had a C-index of 0.753 (95% confidence interval [CI]: 0.780–0.726) and 0.751 (95% CI: 0.794–0.708) in the training and the validation cohorts, respectively. Internal and external calibration curves indicated satisfactory agreement between nomogram prediction and actual survival, and DCA indicated its clinical usefulness. Furthermore, a risk stratification system was established that was able to accurately stratify mCEC patients into three risk subgroups with significantly different prognosis.Conclusions: We constructed the first nomogram and corresponding risk classification system to predict the OS of mCEC patients. These tools showed satisfactory accuracy, and clinical utility, and could aid in patient counseling and individualized clinical decision-making. |
| first_indexed | 2024-12-19T07:55:21Z |
| format | Article |
| id | doaj.art-d5e9a125681e4256a98fe118b9d37786 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-19T07:55:21Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-d5e9a125681e4256a98fe118b9d377862022-12-21T20:30:01ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-11-01910.3389/fonc.2019.01106478899Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment SystemShilong Zhang0Shilong Zhang1Xin Wang2Zhanming Li3Zhanming Li4Wenrong Wang5Lishun Wang6Lishun Wang7Minhang Hospital, Fudan University, Shanghai, ChinaInstitute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Acupuncture and Moxibustion, Central Hospital of Shanghai Xuhui District, Shanghai, ChinaMinhang Hospital, Fudan University, Shanghai, ChinaInstitute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, Shanghai, ChinaFaculty of Physical Education, Shandong Normal University, Jinan, ChinaMinhang Hospital, Fudan University, Shanghai, ChinaInstitute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, Shanghai, ChinaBackground: Metastatic cervical cancer (mCEC) is the end stage of cervical cancer. This study aimed to establish and validate a nomogram to predict the overall survival (OS) of mCEC patients.Methods: We investigated the Surveillance, Epidemiology, and End Results (SEER) database for mCEC patients diagnosed between 2010 and 2014. Univariate and multivariable Cox analyses was performed to select the clinically important predictors of OS when developing the nomogram. The performance of nomogram was validated with Harrell's concordance index (C-index), calibration curves, receiver operating characteristic curve (ROC), and decision curve analysis (DCA).Results: One thousand two hundred and fifty-two mCEC patients were included and were divided into training (n = 880) and independent validation (n = 372) cohorts. Age, race, pathological type, histology grade, radiotherapy, and chemotherapy were independent predictors of OS and used to develop the nomogram for predicting 1- and 3-year OS. This nomogram had a C-index of 0.753 (95% confidence interval [CI]: 0.780–0.726) and 0.751 (95% CI: 0.794–0.708) in the training and the validation cohorts, respectively. Internal and external calibration curves indicated satisfactory agreement between nomogram prediction and actual survival, and DCA indicated its clinical usefulness. Furthermore, a risk stratification system was established that was able to accurately stratify mCEC patients into three risk subgroups with significantly different prognosis.Conclusions: We constructed the first nomogram and corresponding risk classification system to predict the OS of mCEC patients. These tools showed satisfactory accuracy, and clinical utility, and could aid in patient counseling and individualized clinical decision-making.https://www.frontiersin.org/article/10.3389/fonc.2019.01106/fullnomogrammetastatic cervical cancerSEERoverall survivaldecision curve analysis |
| spellingShingle | Shilong Zhang Shilong Zhang Xin Wang Zhanming Li Zhanming Li Wenrong Wang Lishun Wang Lishun Wang Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System Frontiers in Oncology nomogram metastatic cervical cancer SEER overall survival decision curve analysis |
| title | Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System |
| title_full | Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System |
| title_fullStr | Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System |
| title_full_unstemmed | Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System |
| title_short | Score for the Overall Survival Probability of Patients With First-Diagnosed Distantly Metastatic Cervical Cancer: A Novel Nomogram-Based Risk Assessment System |
| title_sort | score for the overall survival probability of patients with first diagnosed distantly metastatic cervical cancer a novel nomogram based risk assessment system |
| topic | nomogram metastatic cervical cancer SEER overall survival decision curve analysis |
| url | https://www.frontiersin.org/article/10.3389/fonc.2019.01106/full |
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