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Development and validation of a nomogram to predict cancer-specific survival of uveal melanoma.
Zeng, Qiaozhu; Yao, Yuou; Zhao, Mingwei.
Afiliación
  • Zeng Q; Department of Ophthalmology, Eye Diseases and Optometry Institute, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, Xicheng District, China.
  • Yao Y; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China.
  • Zhao M; Department of Ophthalmology, Eye Diseases and Optometry Institute, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, Xicheng District, China.
BMC Ophthalmol ; 21(1): 230, 2021 May 25.
Article en En | MEDLINE | ID: mdl-34030647
BACKGROUND: Uveal melanoma (UM) is a rare but aggressive cancer, which is the most common primary intraocular malignancy in adults. We aimed to develop and validate a competing risk nomogram to predict cancer-specific survival (CSS) of patients with UM, as well as compare its prognostic value with that of the American Joint Committee on Cancer (AJCC) staging system. METHODS: Data of patients diagnosed with UM from 2010 to 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We extracted and integrated significant prognostic factors based on competing risk regression to build a nomogram. The nomogram with an online prediction version was also created. The performance of the nomogram was evaluated using Harrell's concordance index (C-index) and calibration plots. Receiver operating characteristic (ROC) curve was carried out to estimate clinical applicability of the model. Improvements in the predictive accuracy of our new model compared with AJCC staging system were estimated by calculating the relative integrated discrimination improvement (IDI) and the net reclassification improvement (NRI). RESULTS: A total of 839 eligible patients with primary UM were randomly assigned to a training cohort (588, 70%) and a validation cohort (251, 30%). Age, histological type, T stage and M stage were independent prognostic factors to predict CSS of UM and were incorporated in the nomogram. The calibration plots indicated that the 3- and 5-year CSS probabilities were consistent between the nomogram prediction and the actual observation. The C-index for this model was 0.778 (95% CI:0.756-0.800) and 0.786 (95% CI: 0.749-0.816) in the training cohort and validation cohort. Areas under the curve (AUCs) were 0.814, 0.771, and 0.792 in the training cohort, 0.788, 0.781 and 0.804 in the validation cohort, respectively. The NRI value in AJCC staging system was - 0.153 (95% CI -0.29 - - 0.041) for 3 years of follow-up and - 0.276 (95% CI -0.415 - - 0.132) for 5 years of follow-up. The IDI values for 3 and 5 years of follow-up in the AJCC staging system were - 0.021 (P = 0.076) and - 0.045 (P = 0.004), respectively. CONCLUSIONS: We have developed and validated a competing risk nomogram to reliably predict cancer-specific survival of patients with UM. This convenient tool may be useful for evaluating cancer-specific prognosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nomogramas / Melanoma Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: BMC Ophthalmol Asunto de la revista: OFTALMOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nomogramas / Melanoma Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: BMC Ophthalmol Asunto de la revista: OFTALMOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido