A Web-Based Prediction Model for Overall Survival of Elderly Patients With Malignant Bone Tumors: A Population-Based Study.

Jinkui Wang,Jie Tang,Xiudan Pan

doi:10.3389/fpubh.2021.812395

Abstract

Background: Malignant bone tumors (MBT) are one of the causes of death in elderly patients. The purpose of our study is to establish a nomogram to predict the overall survival (OS) of elderly patients with MBT.Methods: The clinicopathological data of all elderly patients with MBT from 2004 to 2018 were downloaded from the SEER database. They were randomly assigned to the training set (70%) and validation set (30%). Univariate and multivariate Cox regression analysis was used to identify independent risk factors for elderly patients with MBT. A nomogram was built based on these risk factors to predict the 1-, 3-, and 5-year OS of elderly patients with MBT. Then, used the consistency index (C-index), calibration curve, and the area under the receiver operating curve (AUC) to evaluate the accuracy and discrimination of the prediction model was. Decision curve analysis (DCA) was used to assess the clinical potential application value of the nomogram. Based on the scores on the nomogram, patients were divided into high- and low-risk groups. The Kaplan-Meier (K-M) curve was used to test the difference in survival between the two patients.Results: A total of 1,641 patients were included, and they were randomly assigned to the training set (N = 1,156) and the validation set (N = 485). The univariate and multivariate analysis of the training set suggested that age, sex, race, primary site, histologic type, grade, stage, M stage, surgery, and tumor size were independent risk factors for elderly patients with MBT. The C-index of the training set and the validation set were 0.779 [0.759–0.799] and 0.801 [0.772–0.830], respectively. The AUC of the training and validation sets also showed similar results. The calibration curves of the training and validation sets indicated that the observed and predicted values were highly consistent. DCA suggested that the nomogram had potential clinical value compared with traditional TNM staging.Conclusion: We had established a new nomogram to predict the 1-, 3-, 5-year OS of elderly patients with MBT. This predictive model can help doctors and patients develop treatment plans and follow-up strategies.

Highlights

The most common malignant bone tumors (MBT) in elderly patients include osteosarcoma, chondrosarcoma, and chord sarcoma
About 60% of osteosarcoma patients occur under 20 years of age, and ∼10% of patients occur over 60 years of age [1]
There is no significant difference between the clinical-pathological data of the patients in the training set and the validation set

Summary

Introduction

The most common malignant bone tumors (MBT) in elderly patients include osteosarcoma, chondrosarcoma, and chord sarcoma. Chondrosarcoma accounts for about 9.2% of all primary MBT, with an annual incidence of 1/200,000 and an average age of onset of about 50 years old [5, 6]. It is the second most common bone malignant tumor after osteosarcoma. Chord sarcoma accounts for 1% to 4% of primary bone tumors, and the ratio of males to females is about 1.8:1 It can occur at any age, including children and adolescents, and is most common in patients between 50 and 60 years old (30%). The purpose of our study is to establish a nomogram to predict the overall survival (OS) of elderly patients with MBT

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Conclusion