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Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database

OBJECTIVES: Clear cell renal cell carcinoma (ccRCC) is highly prevalent, prone to metastasis, and has a poor prognosis after metastasis. Therefore, this study aimed to develop a prognostic model to predict the individualized prognosis of patients with metastatic clear cell renal cell carcinoma (mccR...

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Autores principales: Huang, Guangyi, Liao, Jie, Cai, Songwang, Chen, Zheng, Qin, Xiaoping, Ba, Longhong, Rao, Jingmin, Zhong, Weimin, Lin, Ying, Liang, Yuying, Wei, Liwei, Li, Jinhua, Deng, Kaifeng, Li, Xiangyue, Guo, Zexiong, Wang, Liang, Zhuo, Yumin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552762/
https://www.ncbi.nlm.nih.gov/pubmed/36237316
http://dx.doi.org/10.3389/fonc.2022.949058
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author Huang, Guangyi
Liao, Jie
Cai, Songwang
Chen, Zheng
Qin, Xiaoping
Ba, Longhong
Rao, Jingmin
Zhong, Weimin
Lin, Ying
Liang, Yuying
Wei, Liwei
Li, Jinhua
Deng, Kaifeng
Li, Xiangyue
Guo, Zexiong
Wang, Liang
Zhuo, Yumin
author_facet Huang, Guangyi
Liao, Jie
Cai, Songwang
Chen, Zheng
Qin, Xiaoping
Ba, Longhong
Rao, Jingmin
Zhong, Weimin
Lin, Ying
Liang, Yuying
Wei, Liwei
Li, Jinhua
Deng, Kaifeng
Li, Xiangyue
Guo, Zexiong
Wang, Liang
Zhuo, Yumin
author_sort Huang, Guangyi
collection PubMed
description OBJECTIVES: Clear cell renal cell carcinoma (ccRCC) is highly prevalent, prone to metastasis, and has a poor prognosis after metastasis. Therefore, this study aimed to develop a prognostic model to predict the individualized prognosis of patients with metastatic clear cell renal cell carcinoma (mccRCC). PATIENTS AND METHODS: Data of 1790 patients with mccRCC, registered from 2010 to 2015, were extracted from the Surveillance, Epidemiology and End Results (SEER) database. The included patients were randomly divided into a training set (n = 1253) and a validation set (n = 537) based on the ratio of 7:3. The univariate and multivariate Cox regression analyses were used to identify the important independent prognostic factors. A nomogram was then constructed to predict cancer specific survival (CSS). The performance of the nomogram was internally validated by using the concordance index (C-index), calibration plots, receiver operating characteristic curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). We compared the nomogram with the TNM staging system. Kaplan–Meier survival analysis was applied to validate the application of the risk stratification system. RESULTS: Diagnostic age, T-stage, N-stage, bone metastases, brain metastases, liver metastases, lung metastases, chemotherapy, radiotherapy, surgery, and histological grade were identified as independent predictors of CSS. The C-index of training and validation sets are 0.707 and 0.650 respectively. In the training set, the AUC of CSS predicted by nomogram in patients with mccRCC at 1-, 3- and 5-years were 0.770, 0.758, and 0.757, respectively. And that in the validation set were 0.717, 0.700, and 0.700 respectively. Calibration plots also showed great prediction accuracy. Compared with the TNM staging system, NRI and IDI results showed that the predictive ability of the nomogram was greatly improved, and DCA showed that patients obtained clinical benefits. The risk stratification system can significantly distinguish the patients with different survival risks. CONCLUSION: In this study, we developed and validated a nomogram to predict the CSS rate in patients with mccRCC. It showed consistent reliability and clinical applicability. Nomogram may assist clinicians in evaluating the risk factors of patients and formulating an optimal individualized treatment strategy.
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spelling pubmed-95527622022-10-12 Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database Huang, Guangyi Liao, Jie Cai, Songwang Chen, Zheng Qin, Xiaoping Ba, Longhong Rao, Jingmin Zhong, Weimin Lin, Ying Liang, Yuying Wei, Liwei Li, Jinhua Deng, Kaifeng Li, Xiangyue Guo, Zexiong Wang, Liang Zhuo, Yumin Front Oncol Oncology OBJECTIVES: Clear cell renal cell carcinoma (ccRCC) is highly prevalent, prone to metastasis, and has a poor prognosis after metastasis. Therefore, this study aimed to develop a prognostic model to predict the individualized prognosis of patients with metastatic clear cell renal cell carcinoma (mccRCC). PATIENTS AND METHODS: Data of 1790 patients with mccRCC, registered from 2010 to 2015, were extracted from the Surveillance, Epidemiology and End Results (SEER) database. The included patients were randomly divided into a training set (n = 1253) and a validation set (n = 537) based on the ratio of 7:3. The univariate and multivariate Cox regression analyses were used to identify the important independent prognostic factors. A nomogram was then constructed to predict cancer specific survival (CSS). The performance of the nomogram was internally validated by using the concordance index (C-index), calibration plots, receiver operating characteristic curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). We compared the nomogram with the TNM staging system. Kaplan–Meier survival analysis was applied to validate the application of the risk stratification system. RESULTS: Diagnostic age, T-stage, N-stage, bone metastases, brain metastases, liver metastases, lung metastases, chemotherapy, radiotherapy, surgery, and histological grade were identified as independent predictors of CSS. The C-index of training and validation sets are 0.707 and 0.650 respectively. In the training set, the AUC of CSS predicted by nomogram in patients with mccRCC at 1-, 3- and 5-years were 0.770, 0.758, and 0.757, respectively. And that in the validation set were 0.717, 0.700, and 0.700 respectively. Calibration plots also showed great prediction accuracy. Compared with the TNM staging system, NRI and IDI results showed that the predictive ability of the nomogram was greatly improved, and DCA showed that patients obtained clinical benefits. The risk stratification system can significantly distinguish the patients with different survival risks. CONCLUSION: In this study, we developed and validated a nomogram to predict the CSS rate in patients with mccRCC. It showed consistent reliability and clinical applicability. Nomogram may assist clinicians in evaluating the risk factors of patients and formulating an optimal individualized treatment strategy. Frontiers Media S.A. 2022-09-28 /pmc/articles/PMC9552762/ /pubmed/36237316 http://dx.doi.org/10.3389/fonc.2022.949058 Text en Copyright © 2022 Huang, Liao, Cai, Chen, Qin, Ba, Rao, Zhong, Lin, Liang, Wei, Li, Deng, Li, Guo, Wang and Zhuo 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
Huang, Guangyi
Liao, Jie
Cai, Songwang
Chen, Zheng
Qin, Xiaoping
Ba, Longhong
Rao, Jingmin
Zhong, Weimin
Lin, Ying
Liang, Yuying
Wei, Liwei
Li, Jinhua
Deng, Kaifeng
Li, Xiangyue
Guo, Zexiong
Wang, Liang
Zhuo, Yumin
Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title_full Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title_fullStr Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title_full_unstemmed Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title_short Development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: A study based on SEER database
title_sort development and validation of a prognostic nomogram for predicting cancer-specific survival in patients with metastatic clear cell renal carcinoma: a study based on seer database
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552762/
https://www.ncbi.nlm.nih.gov/pubmed/36237316
http://dx.doi.org/10.3389/fonc.2022.949058
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