浆液性卵巢癌治疗后远期生存列线图预测模型的构建和验证

目的构建并验证浆液性卵巢癌远期生存概率的列线图,为卵巢癌患者提供个性化的治疗建议和随访策略。方法共有6957例来自SEER数据库的患者被纳入训练组;外部验证组数据来自于1244例患者的临床资料。基于Cox回归模型构建列线图,使用一致性指数、受试者操作特征曲线、校准图进行验证。绘制Kaplan-Meier曲线比较不同风险亚组之间的生存结果。决策曲线分析用于检验列线图的临床价值。结果多因素分析结果显示,构建列线图的独立影响因素为年龄、肿瘤级别和AJCC分期。训练组和验证组中,总生存期(OS)的一致性指数分别为0.689(95%CI为0.677~0.701)和0.639(95%CI为0.601~0.670),ROC曲线下面积(AUC)分别为0.675和0.661。校准曲线显示列线图预测的生存概率与实际生存3年和5年OS之间具有良好的一致性。不同风险亚组的K-M曲线显示具有显著差异(P<0.001)。决策曲线分析表明列线图的临床价值优于AJCC分期系统。结论该列线图较好地提供了对卵巢浆液性癌个体化、可视化和量化的生存预测,这将有助于医生为患者提供个性化治疗建议和随访策略。

Development and validation of nomogram to predict long-term survival outcome in serous ovarian cancer after treatment

Objective:To develope and validate a nomogram to predict overall survival(OS)in serous ovarian cancer(SOC),which may provide personalized treatment suggestions and follow-up strategies for patients with ovarian cancer.Methods:A total of 6957 patients from SEER database were included in the training group.The data of external validation group were from the clinical data of 1244 patients.The nomogram was structured on Cox regression analyses and was evaluated in both the training and validation groups using consistency index,Receiver Operating Characteristic,calibration plots,and risk subgroup classification.Kaplan-Meier curves were plotted to compare survival outcomes between subgroups.A decision-curve analysis was used to detect the clinical value of the nomogram.Results:The independent factors identified by multivariate analysis in the training cohort and selected for the nomogram included age,tumor grade,and AJCC stage.The consistency indexes for OS were 0.689(95%confidence interval:0.677~0.701)in the training cohort and 0.639(95%confidence interval:0.601~0.670)in the validation cohort;the AUCs were 0.675 and 0.661 in the validation cohorts,respectively.Calibration curves showed good consistency between predicted and actual 3-and 5-year OS.Significant differences were observed in the survival curves of different risk subgroups(P<0.001).The decision-curve analysis indicated our nomogram was superior to the AJCC staging system.Conclusion:This nomogram provides a better prediction of individualized,visual and quantitative survival of SOC,which will help provide personalized treatments and follow-up strategies.