Abstract
Background: Medulloblastoma (MB) is one of the most malignant neuroepithelial tumors in the central nervous system. This study aimed to establish an effective prognostic nomogram and risk grouping system for predicting overall survival (OS) of patients with MB. Materials and Methods: The nomogram was constructed based on data from the database of Surveillance, Epidemiology, and End Results (SEER). This database consisted of 2,824 patients with medulloblastoma and was used as the training cohort. The data of another additional 161 patients treated at the Sun Yat-sen University Cancer Center (SYSUCC) were used as the external validation cohort. Cox regression analysis was used to select independent prognostic factors. Concordance index (C-index) and calibration curve were used to predict the prognostic effect of the nomogram for overall survival. Results: In the training cohort, Cox regression analyses showed that the prognostic factors included histopathology, surgery, radiotherapy, chemotherapy, tumor size, dissemination, and age at diagnosis. The internal and external validated C-indexes were 0.681 and 0.644, respectively. Calibration curves showed that the nomogram was able to predict 1-, 3-, and 5-year OS for patients with MB precisely. Using the training cohort, a risk grouping system was built, which could perfectly classify patients into four risk nomogroups with a 5-year survival rate of 83.9%, 76.5%, 64.5%, and 46.8%, respectively. Conclusion: We built and validated a nomogram and risk grouping system that can provide individual prediction of OS and distinguish MB patients from different risk groups. This nomogram and risk grouping system could help clinicians making better treatment plan and prognostic assessment.
Highlights
Medulloblastoma (MB) is one of the most malignant brain tumors in children (Khanna et al, 2017; Leece et al, 2017)
A total of 2,824 patients were identified from the SEER database as suitable for inclusion in the study and they were grouped as the training cohort (Figure 1)
According to the cox regression analyses, we identified histopathology, surgery, radiotherapy, chemotherapy, tumor size, dissemination, and age of patients as independent factors correlated with the 1, 3, and 5-year overall survival (OS) rates in the training cohort (Table 2)
Summary
Medulloblastoma (MB) is one of the most malignant brain tumors in children (Khanna et al, 2017; Leece et al, 2017). It is essential to set up an effective prognostic model for accurately identifying such patients for better treatment and surveillance evaluation (He et al, 2018; Wu et al, 2019). As for molecular classification in the 2016 WHO classification, four principal molecular subgroups based on transcriptome and methylome profiling, including Wingless (WNT), Sonic Hedgehog (SHH), group 3 (G3), and group 4 (G4), were identified to be significantly better correlated with different prognosis than traditional subtypes (Taylor et al, 2012; Louis et al, 2016; Liu et al, 2017; Vo et al, 2018). This study aimed to establish an effective prognostic nomogram and risk grouping system for predicting overall survival (OS) of patients with MB
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