A nomogram for predicting cancer-specific survival and overall survival in elderly patients with nonmetastatic renal cell carcinoma

作者全名："Zhanghuang, Chenghao; Wang, Jinkui; Zhang, Zhaoxia; Yao, Zhigang; Ji, Fengming; Li, Li; Xie, Yucheng; Yang, Zhen; Tang, Haoyu; Zhang, Kun; Wu, Chengchuang; Yan, Bing"

作者地址："[Zhanghuang, Chenghao; Yao, Zhigang; Ji, Fengming; Tang, Haoyu; Zhang, Kun; Wu, Chengchuang; Yan, Bing] Kunming Med Univ, Kunming Childrens Hosp, Yunnan Prov Clin Res Ctr Childrens Hlth & Dis, Dept Urol,Childrens Hosp, Kunming, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui; Zhang, Zhaoxia] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Urol, Chongqing Key Lab Children Urogenital Dev & Tissue, Chongqing, Peoples R China; [Zhanghuang, Chenghao; Li, Li; Yan, Bing] Kunming Med Univ, Kunming Childrens Hosp, Yunnan Key Lab Childrens Major Dis Res, Childrens Hosp, Kunming, Peoples R China; [Xie, Yucheng] Kunming Med Univ, Kunming Childrens Hosp, Dept Pathol, Childrens Hosp, Kunming, Peoples R China; [Yang, Zhen] Kunming Med Univ, Kunming Childrens Hosp, Yunnan Children Solid Tumor Treatment Ctr, Dept Oncol,Childrens Hosp, Kunming, Peoples R China"

通信作者："Yan, B (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Yunnan Prov Clin Res Ctr Childrens Hlth & Dis, Dept Urol,Childrens Hosp, Kunming, Peoples R China.; Yan, B (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Yunnan Key Lab Childrens Major Dis Res, Childrens Hosp, Kunming, Peoples R China."

来源：FRONTIERS IN SURGERY

ESI学科分类：　

WOS号：WOS:000916467600001

JCR分区：Q2

影响因子：1.6

年份：2023

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：nomogram; cancer-specific survival; elderly patients; nonmetastatic renal cell carcinoma; SEER; overall survival

摘要："BackgroundRenal cell carcinoma (RCC) is a common malignant tumor in the elderly, with an increasing trend in recent years. We aimed to construct a nomogram of cancer-specific survival (CSS) and overall survival (OS) in elderly patients with nonmetastatic renal cell carcinoma (nmRCC). MethodsClinicopathological information was downloaded from the Surveillance, Epidemiology, and End Results (SEER) program in elderly patients with nmRCC from 2010 to 2015. All patients were randomly assigned to a training cohort (70%) or a validation cohort (30%). Univariate and multivariate Cox regression analyses were used to identify independent risk factors for patient outcomes in the training cohort. A nomogram was constructed based on these independent risk factors to predict the 1-, 3-, and 5-year CSS and OS in elderly patients with nmRCC. We used a range of methods to validate the accuracy and reliability of the model, including the calibration curve, consistency index (C-index), and the area under the receiver operating curve (AUC). Decision curve analysis (DCA) was used to test the clinical utility of the model. ResultsA total of 12,116 patients were enrolled in the study. Patients were randomly assigned to the training cohort (N = 8,514) and validation cohort (N = 3,602). In the training cohort, univariate and multivariate Cox regression analysis showed that age, marriage, tumor histological type, histological tumor grade, TN stage, tumor size, and surgery are independent risk factors for prognosis. A nomogram was constructed based on independent risk factors to predict CSS and OS at 1-, 3-, and 5- years in elderly patients with nmRCC. The C-index of the training and validation cohorts in CSS were 0.826 and 0.831; in OS, they were 0.733 and 0.734, respectively. The AUC results of the training and validation cohort were similar to the C-index. The calibration curve indicated that the observed value is highly consistent with the predicted value, meaning the model has good accuracy. DCA results suggest that the clinical significance of the nomogram is better than that of traditional TNM staging. ConclusionsWe built a nomogram prediction model to predict the 1-, 3- and 5-year CSS and OS of elderly nmRCC patients. This model has good accuracy and discrimination and can help doctors and patients make clinical decisions and active monitoring."

基金机构：Yunnan Education Department of Science Research Fund [2020 J0228]; Kunming City Health Science and Technology Talent "1000" training Project [2020- SW (Reserve)-112]; Kunming Health and Health Commission Health Research Project [2020-0201-001]; Kunming Medical Joint Project of Yunnan Science and Technology Department [202001 AY070001-271]; Open Research Fund of Clinical Research Center for Children's Health and Diseases of Yunnan Province [2022-ETYY-YJ-03]

基金资助正文："This study was supported by Yunnan Education Department of Science Research Fund (grant no. 2020 J0228), Kunming City Health Science and Technology Talent ""1000"" training Project [grant no. 2020- SW (Reserve)-112], Kunming Health and Health Commission Health Research Project (grant no. 2020-0201-001), Kunming Medical Joint Project of Yunnan Science and Technology Department (grant no. 202001 AY070001-271), and Open Research Fund of Clinical Research Center for Children's Health and Diseases of Yunnan Province (grant no. 2022-ETYY-YJ-03). The funding bodies played no role in the study's design and collection, analysis and interpretation of data, and writing the manuscript."