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A prognostic nomogram for the cancer-specific survival of patients with upper-tract urothelial carcinoma based on the Surveillance, Epidemiology, and End Results Database.

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机构: [1]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China. [2]School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China. [3]School of Public Health, Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, China. [4]Cardiovascular Research Center, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, People’s Republic of China. [5]Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China.
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关键词: Upper-tract urothelial carcinoma Nomogram SEER Cancer-specific survival

摘要:
The aim of this study was to establish a comprehensive nomogram for the cancer-specific survival (CSS) of patients with upper-tract urothelial carcinoma (UTUC) and compare it with the traditional American Joint Committee on Cancer (AJCC) staging system in order to determine its reliability. This study analyzed 9505 patients with UTUC in the Surveillance, Epidemiology, and End Results (SEER) database. R software was used to randomly divided the patients in a 7-to-3 ratio to form a training cohort (n = 6653) and a validation cohort (n = 2852). Multivariable Cox regression was used to identify predictive variables. The new survival model was compared with the AJCC prognosis model using the concordance index (C-index), the area under the time-dependent receiver operating characteristics curve (AUC), the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), calibration plotting, and decision-curve analysis (DCA). We have established a nomogram for determining the 3-, 5-, and 8-year CSS probabilities of UTUC patients. The nomogram indicates that the AJCC stage has the greatest influence on CSS in UTUC, followed by the age at diagnosis, surgery status, tumor size, radiotherapy status, histological grade, marital status, chemotherapy status, race, and finally sex. The C-index was higher for the nomogram than the AJCC staging system in both the training cohort (0.785 versus 0.747) and the validation cohort (0.779 versus 0.739). Calibration plotting demonstrated that the model has good calibration ability. The AUC, NRI, IDI, and DCA of the nomogram showed that it performs better than the AJCC staging system alone. This study is the first to establish a comprehensive UTUC nomogram based on the SEER database and evaluate it using a series of indicators. Our novel nomogram can help clinical staff to predict the 3-, 5-, and 8-year CSS probabilities of UTUC patients more accurately than using the AJCC staging system.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
第一作者:
第一作者机构: [1]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China. [2]School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China.
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通讯作者:
通讯机构: [1]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China. [2]School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China. [4]Cardiovascular Research Center, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, People’s Republic of China. [5]Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China.
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