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Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study
Craniopharyngiomas (CPs) are benign tumors arising from the sellar region. However, little is known about their clinical features and long-term recurrence due to low morbidity and the lack of large cohort studies. Thus, we aimed to develop nomograms to accurately predict the extent of resection and...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312552/ https://www.ncbi.nlm.nih.gov/pubmed/34322389 http://dx.doi.org/10.3389/fonc.2021.691288 |
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author | Xu, Dingkang Wei, Qingjie Li, Zhe Hu, Yan Hu, Peizhu Zhao, Shengqi Song, Dengpan Lei, Shixiong Zhang, Mingchu Gao, Qiang Zhang, Longxiao Lin, Fangbo Zuo, Yuchao Liu, Xianzhi Feng, Mengzhao Ma, Chunxiao Guo, Fuyou |
author_facet | Xu, Dingkang Wei, Qingjie Li, Zhe Hu, Yan Hu, Peizhu Zhao, Shengqi Song, Dengpan Lei, Shixiong Zhang, Mingchu Gao, Qiang Zhang, Longxiao Lin, Fangbo Zuo, Yuchao Liu, Xianzhi Feng, Mengzhao Ma, Chunxiao Guo, Fuyou |
author_sort | Xu, Dingkang |
collection | PubMed |
description | Craniopharyngiomas (CPs) are benign tumors arising from the sellar region. However, little is known about their clinical features and long-term recurrence due to low morbidity and the lack of large cohort studies. Thus, we aimed to develop nomograms to accurately predict the extent of resection and tumor recurrence using clinical parameters. A total of 545 patients diagnosed with CP between 2009 and 2019 were examined: 381 in the development cohort and 164 in the validation cohort. Least absolute shrinkage and selection operator (LASSO) and Cox regression analyses were performed to establish two nomograms. Receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA) and Kaplan-Meier (KM) curves were used to evaluate their predictive performance and discriminative power, respectively, in the two cohorts. In addition, the EORTC QLQ-BN20 questionnaire was used to assess neuropsychological status in the follow-up. In the development cohort, the area under the curve (AUC) and C-index were 0.760 and 0.758, respectively, for predicting the extent of resection and 0.78 and 0.75, respectively, for predicting 3-year progression-free survival (PFS) and 5-year PFS. Additionally, the model had a predictive accuracy of 0.785. Both nomograms showed acceptable discrimination in the two cohorts. Moreover, DCA demonstrated excellent clinical benefits from the two nomograms. Finally, participants were classified into two distinct risk groups according to the risk score, and an online calculator was created for convenient clinical use. During long term follow-up, hypothyroidism (77.61%) and hypocortisolism (76.70%) were the most common endocrine dysfunction after surgery and significant deficits were observed concerning visual disorder, motor dysfunction and seizures in the recurrent groups. In particular, better quality of life was associated with gross total resection (GTR), postoperative radiation, anterior interhemispheric (AI) approach and transsphenoidal approach. To our knowledge, these are the first nomograms based on a very large cohort of patients with CP that show potential benefits for guiding treatment decisions and long-term surveillance. The current study demonstrated the online calculator serve as the practical tool for individual strategies based on the patient’s baseline characteristics to achieve a better prognosis. |
format | Online Article Text |
id | pubmed-8312552 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83125522021-07-27 Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study Xu, Dingkang Wei, Qingjie Li, Zhe Hu, Yan Hu, Peizhu Zhao, Shengqi Song, Dengpan Lei, Shixiong Zhang, Mingchu Gao, Qiang Zhang, Longxiao Lin, Fangbo Zuo, Yuchao Liu, Xianzhi Feng, Mengzhao Ma, Chunxiao Guo, Fuyou Front Oncol Oncology Craniopharyngiomas (CPs) are benign tumors arising from the sellar region. However, little is known about their clinical features and long-term recurrence due to low morbidity and the lack of large cohort studies. Thus, we aimed to develop nomograms to accurately predict the extent of resection and tumor recurrence using clinical parameters. A total of 545 patients diagnosed with CP between 2009 and 2019 were examined: 381 in the development cohort and 164 in the validation cohort. Least absolute shrinkage and selection operator (LASSO) and Cox regression analyses were performed to establish two nomograms. Receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA) and Kaplan-Meier (KM) curves were used to evaluate their predictive performance and discriminative power, respectively, in the two cohorts. In addition, the EORTC QLQ-BN20 questionnaire was used to assess neuropsychological status in the follow-up. In the development cohort, the area under the curve (AUC) and C-index were 0.760 and 0.758, respectively, for predicting the extent of resection and 0.78 and 0.75, respectively, for predicting 3-year progression-free survival (PFS) and 5-year PFS. Additionally, the model had a predictive accuracy of 0.785. Both nomograms showed acceptable discrimination in the two cohorts. Moreover, DCA demonstrated excellent clinical benefits from the two nomograms. Finally, participants were classified into two distinct risk groups according to the risk score, and an online calculator was created for convenient clinical use. During long term follow-up, hypothyroidism (77.61%) and hypocortisolism (76.70%) were the most common endocrine dysfunction after surgery and significant deficits were observed concerning visual disorder, motor dysfunction and seizures in the recurrent groups. In particular, better quality of life was associated with gross total resection (GTR), postoperative radiation, anterior interhemispheric (AI) approach and transsphenoidal approach. To our knowledge, these are the first nomograms based on a very large cohort of patients with CP that show potential benefits for guiding treatment decisions and long-term surveillance. The current study demonstrated the online calculator serve as the practical tool for individual strategies based on the patient’s baseline characteristics to achieve a better prognosis. Frontiers Media S.A. 2021-07-12 /pmc/articles/PMC8312552/ /pubmed/34322389 http://dx.doi.org/10.3389/fonc.2021.691288 Text en Copyright © 2021 Xu, Wei, Li, Hu, Hu, Zhao, Song, Lei, Zhang, Gao, Zhang, Lin, Zuo, Liu, Feng, Ma and Guo https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Xu, Dingkang Wei, Qingjie Li, Zhe Hu, Yan Hu, Peizhu Zhao, Shengqi Song, Dengpan Lei, Shixiong Zhang, Mingchu Gao, Qiang Zhang, Longxiao Lin, Fangbo Zuo, Yuchao Liu, Xianzhi Feng, Mengzhao Ma, Chunxiao Guo, Fuyou Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title | Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title_full | Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title_fullStr | Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title_full_unstemmed | Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title_short | Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study |
title_sort | development and validation of predicting nomograms for craniopharyngioma: a retrospective, multiple-center, cohort study |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312552/ https://www.ncbi.nlm.nih.gov/pubmed/34322389 http://dx.doi.org/10.3389/fonc.2021.691288 |
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