Abstract
This study aimed to construct a widely accepted prognostic nomogram in Chinese high-grade osteosarcoma (HOS) patients aged ≤ 30 years to provide insight into predicting 5-year overall survival (OS). Data from 503 consecutive HOS patients at our centre between 12/2012 and 05/2019 were retrospectively collected. Eighty-four clinical features and routine laboratory haematological and biochemical testing indicators of each patient at the time of diagnosis were collected. A prognostic nomogram model for predicting OS was constructed based on the Cox proportional hazards model. The performance was assessed by the concordance index (C-index), receiver operating characteristic curve and calibration curve. The utility was evaluated by decision curve analysis. The 5-year OS was 52.1% and 2.6% for the nonmetastatic and metastatic patients, respectively. The nomogram included nine important variables based on a multivariate analysis: tumour stage, surgical type, metastasis, preoperative neoadjuvant chemotherapy cycle, postoperative metastasis time, mean corpuscular volume, tumour-specific growth factor, gamma-glutamyl transferase and creatinine. The calibration curve showed that the nomogram was able to predict 5-year OS accurately. The C-index of the nomogram for OS prediction was 0.795 (range, 0.703–0.887). Moreover, the decision curve analysis curve also demonstrated the clinical benefit of this model. The nomogram provides an individualized risk estimate of the 5-year OS in patients with HOS aged ≤ 30 years in a Chinese population-based cohort.
Highlights
This study aimed to construct a widely accepted prognostic nomogram in Chinese high-grade osteosarcoma (HOS) patients aged ≤ 30 years to provide insight into predicting 5-year overall survival (OS)
The baseline clinical characteristics of HOS patients in the alive group and death group are presented in Table 1, which lists the baseline demographics and the factors with significant differences, and Supplementary Table S1 lists the factors with continuous variables
The baseline demographics and clinical characteristics of HOS patients in the metastasis group and non-metastasis group are presented in Supplementary Table S2
Summary
This study aimed to construct a widely accepted prognostic nomogram in Chinese high-grade osteosarcoma (HOS) patients aged ≤ 30 years to provide insight into predicting 5-year overall survival (OS). Thanks to the era of neoadjuvant chemotherapy and limb salvage, the overall survival (OS) of non-metastatic HOS has increased to approximately 70% from less than 20% These outcome data cannot be generalized to all patients. Prognostic factors and outcomes have been studied extensively in other countries, the amount of evidence-based information about Chinese HOS patients remains limited and controversial. Only five articles have reported nomogram models of prognosis in Chinese population-based patients with osteosarcoma[4]. One of the purposes of this study was to report the survival outcomes and prognostic factors significantly associated with the OS of HOS in a Chinese population-based cohort. To make our findings more credible, we intend to develop a nomogram to foresee the death risk of HOS based on Chinese patients
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