A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients Undergoing Surgery With Prostate Cancer: A Population-Based Study

作者全名："Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei"

作者地址："[Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] Chongqing Key Lab Children Urogenital Dev & Tissue, Dept Urol, Chongqing, Peoples R China; [Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] Chongqing Key Lab Pediat, Chongqing, Peoples R China; [Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Zhang, Zhaoxia; Zhanghuang, Chenghao; Wang, Jinkui; Mi, Tao; Liu, Jiayan; Tian, Xiaomao; Jin, Liming; He, Dawei] Chongqing Med Univ, Chongqing Higher Inst Engn Res Ctr Childrens Med B, Childrens Hosp, Chongqing, Peoples R China"

通信作者："He, DW (通讯作者)，Chongqing Key Lab Children Urogenital Dev & Tissue, Dept Urol, Chongqing, Peoples R China.; He, DW (通讯作者)，Chongqing Key Lab Pediat, Chongqing, Peoples R China.; He, DW (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; He, DW (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; He, DW (通讯作者)，China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China.; He, DW (通讯作者)，Chongqing Med Univ, Chongqing Higher Inst Engn Res Ctr Childrens Med B, Childrens Hosp, Chongqing, Peoples R China."

来源：FRONTIERS IN PUBLIC HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:000833910900001

JCR分区：Q1

影响因子：5.2

年份：2022

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：nomogram; SEER; prostate cancer; surgery; elderly; CSS

摘要："ObjectiveProstate cancer (PC) is the second leading cause of cancer death in men in the United States after lung cancer in global incidence. Elderly male patients over 65 years old account for more than 60% of PC patients, and the impact of surgical treatment on the prognosis of PC patients is controversial. Moreover, there are currently no predictive models that can predict the prognosis of elderly PC patients undergoing surgical treatment. Therefore, we aimed to construct a new nomogram to predict cancer-specific survival (CSS) in elderly PC patients undergoing surgical treatment. MethodsData for surgically treated PC patients aged 65 years and older were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression models were used to identify independent risk factors for elderly PC patients undergoing surgical treatment. A nomogram of elderly PC patients undergoing surgical treatment was developed based on the multivariate Cox regression model. The consistency index (C-index), the area under the subject operating characteristic curve (AUC), and the calibration curve were used to test the accuracy and discrimination of the predictive model. Decision curve analysis (DCA) was used to examine the potential clinical value of this model. ResultsA total of 44,975 elderly PC patients undergoing surgery in 2010-2018 were randomly assigned to the training set (N = 31705) and validation set (N = 13270). the training set was used for nomogram development and the validation set was used for internal validation. Univariate and multivariate Cox regression model analysis showed that age, marriage, TNM stage, surgical style, chemotherapy, radiotherapy, Gleason score(GS), and prostate-specific antigen(PSA) were independent risk factors for CSS in elderly PC patients undergoing surgical treatment. The C index of the training set and validation indices are 0.911(95%CI: 0.899-0.923) and 0.913(95%CI: 0.893-0.933), respectively, indicating that the nomogram has a good discrimination ability. The AUC and the calibration curves also show good accuracy and discriminability. ConclusionsTo our knowledge, our nomogram is the first predictive model for elderly PC patients undergoing surgical treatment, filling the gap in current predictive models for this PC patient population. Our data comes from the SEER database, which is trustworthy and reliable. Moreover, our model has been internally validated in the validation set using the C-index,AUC and the and the calibration curve, showed that the model have good accuracy and reliability, which can help clinicians and patients make better clinical decision-making. Moreover, the DCA results show that our nomogram has a better potential clinical application value than the TNM staging system."

基金机构：Chongqing Technology Innovation and Application Development [Cstc2019jscx-tjsbX0003]; Yunnan Education Department of Science Research Fund [2020 J0228]; Kunming City Health Science and Technology Talent 1000 training Project; Kunming Health and Health Commission Health Research Project [2020-0201-001]; Kunming Medical Joint Project of Yunnan Science and Technology Department [202001 AY070001-271]

基金资助正文："Funding Special Key Project of Chongqing Technology Innovation and Application Development (No. Cstc2019jscx-tjsbX0003), Yunnan Education Department of Science Research Fund (No. 2020 J0228), Kunming City Health Science and Technology Talent 1000 training Project (No. 2020- SW (Reserve)-112), Kunming Health and Health Commission Health Research Project (No. 2020-0201-001), and Kunming Medical Joint Project of Yunnan Science and Technology Department (No. 202001 AY070001-271)."