Risk Factors, Prognostic Factors, and Nomograms for Bone Metastasis in Patients with Newly Diagnosed Clear Cell Renal Cell Carcinoma: A Large Population-Based Study

Frontiers in Surgery

article

Hongmin Zhou¹  Sheng Yang²  Tiancheng Xie¹  Longfei Wang²  Sen Zhong⁴  Tianyang Sheng⁵  Guoxin Fan⁶  Xiang Liao⁶  Yunfei Xu¹ 

[1] Department of urology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine;Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine;Spinal Pain Research Institute, Tongji University School of Medicine;Shanghai Tongji Hospital, Tongji University School of Medicine;Shanghai East Hospital, Tongji University School of Medicine;National Key Clinical Pain Medicine of China, Huazhong University of Science and Technology Union Shenzhen Hospital;Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Health Science Center;Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, The 6th Affiliated Hospital of Shenzhen University Health Science Center

关键词: clear cell renal cell carcinoma;    bone metastasis;    SEER;    prognostic factors;    nomograms;   

DOI  :  10.3389/fsurg.2022.877653

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background This study aimed to investigate risk factors and prognostic factors in patients with clear cell renal cell carcinoma (ccRCC) with bone metastasis (BM) and establish nomograms to provide a quantitative prediction of the risk of BM and survival probability. Methods The clinicopathological characteristics of patients with ccRCC between January 2010 and December 2015 were obtained from the Surveillance, Epidemiology and End Results (SEER) database. Independent factors for BM in ccRCC patients were identified using univariate and multivariate logistic regression analyses. Prognostic factors for predicting cancer-specific death were evaluated using univariate and multivariate analyses based on a competing risk regression model. We then constructed a diagnostic nomogram and a prognostic nomogram. The two nomograms were evaluated using calibration curves, receiver operating characteristic curves, and decision curve analysis. Results Our study included 34,659 patients diagnosed with ccRCC in the SEER database, with 1,415 patients who presented with bone metastasis. Risk factors for BM in patients with ccRCC included age, stage T, stage N, brain metastasis, liver metastasis, lung metastasis, tumor size, and laterality. Independent prognostic factors for patients with ccRCC patients with BM were Fuhrman grade, tumor size, T stage, N stage, brain metastases, lung metastasis, and surgery. For the diagnostic nomogram, the area under the curve values in the training and testing cohorts were 0.863 (95% CI, 0.851–0.875) and 0.859 (95% CI, 0.839–0.878), respectively. In the prognostic cohort, the area under the curve values for 1-, 2-, and 3-year cancer-specific survival rates in the training cohort were 0.747, 0.774, and 0.780, respectively, and 0.671, 0.706, and 0.696, respectively, in the testing cohort. Through calibration curves and decision curve analyses, the nomograms displayed excellent performance. Conclusions Several factors related to the development and prognosis of BM in patients with ccRCC were identified. The nomograms constructed in this study are expected to become effective and precise tools for clinicians to improve cancer management.

【 授权许可】

CC BY