A nomogram for predicting cancer-specific survival for elderly patients with gallbladder cancer

BMC Gastroenterology

卷:22

Research

Jie Tang¹  Tao Wang²  Hao Luo²  Chong Wen³ 

[1] Department of Biostatistics and Epidemiology, School of Public Health, Shenyang Medical College, Shenyang, China;

[2] General Surgery Center, The General Hospital of Western Theater, 610083, Chengdu, Sichuan Province, China;

[3] General Surgery Center, The General Hospital of Western Theater, 610083, Chengdu, Sichuan Province, China;College of Medicine, Southwest Jiaotong University, Chengdu, China;

关键词: Gallbladder cancer;    Cancer-specific survival;    Elderly patients;    Nomogram;    SEER;   

DOI  :  10.1186/s12876-022-02544-y

 received in 2022-04-24, accepted in 2022-10-18,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundGallbladder cancer (GBC) is a highly aggressive malignancy in elderly patients. Our goal is aimed to construct a novel nomogram to predict cancer-specific survival (CSS) in elderly GBC patients.MethodWe extracted clinicopathological data of elderly GBC patients from the SEER database. We used univariate and multivariate Cox proportional hazard regression analysis to select the independent risk factors of elderly GBC patients. These risk factors were subsequently integrated to construct a predictive nomogram model. C-index, calibration curve, and area under the receiver operating curve (AUC) were used to validate the accuracy and discrimination of the predictive nomogram model. A decision analysis curve (DCA) was used to evaluate the clinical value of the nomogram.ResultA total of 4241 elderly GBC patients were enrolled. We randomly divided patients from 2004 to 2015 into training cohort (n = 2237) and validation cohort (n = 1000), and patients from 2016 to 2018 as external validation cohort (n = 1004). Univariate and multivariate Cox proportional hazard regression analysis found that age, tumor histological grade, TNM stage, surgical method, chemotherapy, and tumor size were independent risk factors for the prognosis of elderly GBC patients. All independent risk factors selected were integrated into the nomogram to predict cancer-specific survival at 1-, 3-, and 5- years. In the training cohort, internal validation cohort, and external validation cohort, the C-index of the nomogram was 0.763, 0.756, and 0.786, respectively. The calibration curves suggested that the predicted value of the nomogram is highly consistent with the actual observed value. AUC also showed the high authenticity of the prediction model. DCA manifested that the nomogram model had better prediction ability than the conventional TNM staging system.ConclusionWe constructed a predictive nomogram model to predict CSS in elderly GBC patients by integrating independent risk factors. With relatively high accuracy and reliability, the nomogram can help clinicians predict the prognosis of patients and make more rational clinical decisions.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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