Abstract
Pseudomyxoma peritonei (PMP) is a rare disease, with the rate of overall survival (OS) influenced by many factors. The present study aimed to define independent predictors and establish a nomogram for individual risk prediction in PMP patients. One hundred forty-seven PMP patients were consecutively included between June 1, 2013, and November 22, 2019. The log-rank test was used to compare the OS rate between groups; subsequently, variables with p < .10 were subjected to multivariate Cox modeling for defining independent prediction indicators. Finally, a nomogram was established based on independent prognosticators and assessed for internal validation. Multivariate Cox analysis showed that D-dimer level, carbohydrate antigen (CA) 125 level, CA 19-9 level, degree of radical surgery, and histological grade were all independently associated with OS in PMP patients. A nomogram was plotted and underwent internal validation. The discrimination ability of the nomogram revealed a good predictive ability as indicated by the C-index value (0.825), and calibration plots confirmed good consistency between the predicted and observed survival probabilities. Five independent prognostic factors for predicting the survival of PMP patients were identified, and the nomogram based on these independent indicators showed a reasonable discrimination ability for individual risk prediction.
Highlights
Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to define independent prediction indicators and establish a nomogram for PMP patients
Multivariate analysis showed Sex, D-Dimer, CA125, CA19-9, peritoneal carcinomatosis index (PCI), and degree of radical surgery were independently associated with OS in PMP patients
In order to ensure the reliability of the research, 734 patients with PMP whose operation were performed not in our center were excluded from present study, the detailed reasons were as follows, for first, different hospitals may use different instruments or methods to detect tumor markers, which cannot guarantee the consistency of test results; secondly, Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) are the optimal treatment for PMP patients, we found that there were still many patients who had only undergone CRS or chemotherapy in nonspecilist hospitals, PMP treatment is best in an inter professional team approach including specialists, oncology trained specialty nursing, and when necessary, pharmacists, collaborating for optimal patient care and outcomes[5], the above 734 subjects were ruled out
Summary
Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to define independent prediction indicators and establish a nomogram for PMP patients. We want to reevaluate whether all the above traditional factors have predictive value for PMP patients, simultaneously, we intend to evaluate the predictive value of new tumor markers (CA724 and CA242) for PMP. On this foundation, a tumor markers based model to predict the prognosis of PMP will be established, which may be helpful in the prognosis judgment and treatment intervention for PMP patients
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