构建和验证用于预测脊柱脊索瘤患者特异性生存率的列线图

Construction and Validation of A Nomogram for Predicting the Specific Survival Rate of Patients with Spinal Chordoma

目的构建并验证预测脊柱脊索瘤患者癌症特异性生存率(CSS)的列线图模型。方法从监测、流行病学和最终结果数据库中选取1998年~2015年脊柱脊索瘤患者316例。按7∶3比例随机分为训练队列和验证队列。采用单因素和多因素Cox分析来确定脊柱脊索瘤患者的独立预后因素,构建预测患者1、3、5年的癌症特异性生存率的列线图。使用训练队列中的数据行列线图的内部验证,验证队列中的数据行列线图的外部验证。结果原发部位、疾病分期、组织学类型、手术、年龄是脊柱脊索瘤患者独立的预后因素。预测1、3和5年CSS的曲线下面积在训练队列中分别为0.821、0.856和0.920,在验证队列中分别为0.728、0.804和0.839。列线图校准曲线显示,列线图所预测的结果与实际观察结果间有较高的一致性。结论列线图为脊柱脊索瘤患者提供了更准确的预后预测,可以使用列线图将患者分为不同的风险群体,从而优化患者的治疗方案。

Objective To construct and validate a nomogram model for predicting the cancer-specific survival rate(CSS)of patients with spinal chordoma.Methods 316 patients with spinal chordoma from 1998 to 2015 were selected from the database of surveillance,epidemiology and final results.According to the ratio of 7∶3,they were randomly divided into training queue and verification queue.Univariate and multivariate Cox analysis were used to determine the independent prognostic factors of patients with spinal chordoma,and to construct a nomogram to predict the cancer-specific survival rate of patients at 1,3,and 5 years.Using the internal verification of the data row and nomogram in the training queue,and the external verification of the data row and nomogram in the verification queue.Results Primary site,disease stage,histological type,surgery,and age were independent prognostic factors for patients with spinal chordoma.The predicted area under the curve of CSS for 1,3,and 5 years was 0.821,0.856,and 0.920 in the training cohort,and 0.728,0.804,and 0.839 in the validation cohort.The calibration curve of the nomogram showed that there was a high consistency between the results predicted by the nomogram and the actual observation results.Conclusion The nomogram provides a more accurate prognostic prediction for patients with spinal chordoma.The nomogram can be used to divide patients into different risk groups to optimize the treatment plan for patients.