Development and Validation of Prognostic Nomograms for Elderly Patients with Osteosarcoma

BACKGROUND: The aim of the current study was to construct prognostic nomograms for individual risk prediction in elderly patients with osteosarcoma. METHODS: Data for 816 elderly patients (≥40 years old) with osteosarcoma between 2004 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database were randomly assigned to training (N=573) and internal validation (N=243) sets. The essential clinical predictors were identified based on least absolute shrinkage and selection operator (Lasso) Cox regression. Nomograms were constructed to predict the 1-, 3-, and 5-year cancer-specific survival (CSS) and overall survival (OS). RESULTS: Our LASSO regression analyses of the training set yielded five clinicopathological features (age, chemotherapy, surgery, AJCC stage, and summary stage) in the training cohort for the prognosis of elderly patients with osteosarcoma, while grade was only associated with OS and M stage was only associated with CSS. Construction of nomograms based on these predictors was performed to evaluate the prognosis of elderly patients with osteosarcoma. The C-index, calibration and decision curve analysis also showed the satisfactory performance of these nomograms for prognosis prediction. CONCLUSION: The constructed nomograms are helpful tools for exactly predicting the prognosis of elderly patients with osteosarcoma, which could enable patients to be more accurately managed in clinical practice.