Postoperative nomogram for 12-year sarcoma-specific death
Postoperative nomogram for 12-year sarcoma-specific death
复制标题
DOI：
10.1200/jco.20.3.791
复制
发表时间：
2002-02-01
影响因子：
45.3
通讯作者：
Brennan, MF
中科院分区：
文献类型：
--
作者：
Kattan, MW;Leung, DHY;Brennan, MF
目的：很少有已发表的研究分析了肉瘤特异性死亡的危险因素。我们开发并内部验证了一个列线图，该列线图结合了预测12年肉瘤特异性死亡概率的因素，使用了一个单一机构治疗的2，136例前瞻性随访成人患者的数据库。诺模图预测变量包括诊断时的年龄、肿瘤大小（小于或等于5、5至10或> 10 cm），组织学分级（高或低），组织学亚型（纤维肉瘤、平滑肌肉瘤、脂肪肉瘤、恶性纤维组织细胞瘤、恶性外周神经肿瘤、滑膜或其他）、深度（浅表或深部）和部位（上肢、下肢、内脏、胸部或躯干、腹后或头部或颈部）。死于肉瘤或治疗并发症是预测的终点。三种预测方法进行了比较，Kaplan-Meier分析的所有可能的子集，递归分割，和考克斯比例风险回归分析。一致性指数被用来作为一个准确的措施与自助纠正乐观的bias.Results：肉瘤特异性死亡在12年是36%（95%的置信区间，33%至39%）。自举校正一致性指数如下：Kaplan-Meier，0.69;递归分割，0.74;和考克斯回归，0.77。根据考克斯回归模型绘制列线图。这个列线图是内部验证使用bootstrapping，并显示有很好的calibration.Conclusion：列线图已开发预测12年肉瘤特异性死亡。该工具可能对患者咨询、随访计划和临床试验合格性确定有用。(C)2002年，美国临床肿瘤学会。
Purpose: Few published studies have analyzed risk factors for sarcoma-specific death. We developed and internally validated a nomogram that combines the factors to predict the probability of 12-year sarcoma-specific death using a database of 2,136 prospectively followed adult patients treated at a single institution.Patients and Methods: Nomogram predictor variables included age at diagnosis, tumor size (less than or equal to 5, 5 to 10, or > 10 cm), histologic grade (high or low), histologic subtype (fibrosarcoma, leiomyosarcoma, liposarcoma, malignant fibrous histiocytoma, malignant peripheral nerve tumor, synovial, or other), depth (superficial or deep), and site (upper extremity, lower extremity, visceral, thoracic or trunk, retrointraabdominal, or head or neck). Death from sarcoma or treatment complication was the predicted end point. Three prediction methods were compared, Kaplan-Meier analysis of all possible subsets, recursive partitioning, and Cox proportional hazards regression analysis. The concordance index was used as an accuracy measure with bootstrapping to correct for optimistic bias.Results: Sarcoma-specific death at 12 years was 36% (95% confidence interval, 33% to 39%). The bootstrap-corrected concordance indices were as follows: Kaplan-Meier, 0.69; recursive partitioning, 0.74; and Cox regression, 0.77. A nomogram was drawn on the basis of the Cox regression model. This nomogram was internally validated using bootstrapping and shown to have excellent calibration.Conclusion: A nomogram has been developed to predict 12-year sarcoma-specific death. This tool may be useful for patient counseling, follow-up scheduling, and clinical trial eligibility determination. (C) 2002 by American Society of Clinical Oncology.