A web-based prediction model for overall survival of elderly patients with early renal cell carcinoma: a population-based study

Journal of Translational Medicine

Tiaoyao Chen¹  Wanting Fu²  Jie Tang³  Zulong Xie⁴  Xiaozhu Liu⁴  Song Yue⁵  Jinkui Wang⁶ 

[1] College of Medical Informatics, The Chongqing Medical University, Chongqing, China;College of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China;Department of Biostatistics and Epidemiology, Public Health School, Shenyang Medical College, Shenyang, China;Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China;Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China;Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China;

关键词: Nomogram;    Elderly patients;    Early RCC;    Overall survival;    SEER;    Online application;   

DOI  :  10.1186/s12967-022-03287-w

来源: Springer

【 摘 要 】

BackgroundThe number of elderly patients with early renal cell carcinoma (RCC) is on the rise. However, there is still a lack of accurate prediction models for the prognosis of early RCC in elderly patients. It is necessary to establish a new nomogram to predict the prognosis of elderly patients with early RCC.MethodsThe data of patients aged above 65 years old with TNM stage I and II RCC were downloaded from the SEER database between 2010 and 2018. The patients from 2010 to 2017 were randomly assigned to the training cohort (n = 7233) and validation cohort (n = 3024). Patient data in 2018(n = 1360) was used for external validation. We used univariable and multivariable Cox regression model to evaluate independent prognostic factors and constructed a nomogram to predict the 1-, 3-, and 5-year overall survival (OS) rates of patients with early-stage RCC. Multiple parameters were used to validate the nomogram, including the consistency index (C-index), the calibration plots, the area under the receiver operator characteristics (ROC) curve, and the decision curve analysis (DCA).ResultsThe study included a total of 11,617 elderly patients with early RCC. univariable and multivariable Cox regression analysis based on predictive variables such as age, sex, histologic type, Fuhrman grade, T stage, surgery type, tumors number, tumor size, and marriage were included to establish a nomogram. The C-index of the training cohort and validation cohort were 0.748 (95% CI: 0.760–0.736) and 0.744 (95% CI: 0.762–0.726), respectively. In the external validation cohort, C-index was 0.893 (95% CI: 0.928–0.858). The calibration plots basically coincides with the diagonal, indicating that the observed OS was almost equal to the predicted OS. It was shown in DCA that the nomogram has more important clinical significance than the traditional TNM stage.ConclusionA novel nomogram was developed to assess the prognosis of an elderly patient with early RCC and to predict prognosis and formulate treatment and follow-up strategies.

【 授权许可】

CC BY