A Prognostic Nomogram Based on Log Odds of Positive Lymph Nodes to Predict Overall Survival for Non-Metastatic Bladder Cancer Patients after Radical Cystectomy.
A Prognostic Nomogram Based on Log Odds of Positive Lymph Nodes to Predict Overall Survival for Non-Metastatic Bladder Cancer Patients after Radical Cystectomy.
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DOI：
10.3390/curroncol29100539
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发表时间：
2022-09-23
期刊：
影响因子：
2.6
通讯作者：
He, Wang
中科院分区：
文献类型：
--
作者：
Yang, Jingtian;Huang, Huasheng;Li, Wenshuang;Ran, Shengming;Hu, Jintao;Zhang, Yishan;Li, Wenjie;Chen, Changhao;He, Wang
(1)目的：评价病理N状态(PN)、淋巴结比(LNR)和阳性淋巴结的对数比(LODDS)对膀胱癌根治性切除术后总生存期(OS)的预测能力。(2)方法：对2004-2017年间10,938例膀胱癌患者的临床病理特征进行统计分析。用单因素和多因素COX回归分析、受试者工作特征曲线下面积(AUC)和C指数评估预测能力。采用校正曲线、决策曲线分析(DCA)和风险分组等方法评价诺模图的预测精度和判别能力。(3)LODDS是膀胱癌的独立危险因素(P均<0.001)，C指数和AUC值最高。训练队列中预测1年、3年和5年OS的AUC值分别为0.747、0.743和0.735。校正曲线和DCA曲线显示了本诺模图良好的临床应用价值。(4)结论：与PN和LNR相比，LODDS是膀胱癌患者更好的预测指标。LODDS融合诺模图对膀胱癌根治术后非转移性膀胱癌具有良好的准确性和临床应用价值。
(1) Purpose: The purpose of this study was to evaluate the prognostic capacity of the pathological N status (pN), lymph node ratio (LNR), and the log odds of positive lymph nodes (LODDS), and to build a prognostic nomogram to predict overall survival (OS) for bladder cancer patients treated by radical cystectomy. (2) Methods: The clinical and pathological characteristics of 10,938 patients with bladder cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017. The predictive capacity was assessed by univariate and multivariate Cox regression analyses, the area under the receiver operating characteristic curve (AUC), and C-index. Calibration curves, decision curve analysis (DCA), and risk-grouping were utilized to evaluate the predictive accuracy and discriminative ability of the nomogram. (3) Results: LODDS was an independent risk factor for bladder cancer (all p < 0.001) and demonstrated the highest values of C-index and AUC. The values of AUCs in the training cohort were 0.747, 0.743, and 0.735 for predicting 1-, 3-, and 5-year OS, respectively. Calibration curves and DCA curves suggested the excellent clinical application value of our nomogram. (4) Conclusions: LODDS is a better predictive indicator for bladder cancer patients compared to pN and LNR. The LODDS-incorporated nomogram has excellent accuracy and promising clinical application value for non-metastatic bladder cancer after radical cystectomy.
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