Abstract
ABSTRACTPurpose:Increased attention has been focused on the survival of renal cell carcinoma (RCC) patients with bone metastasis. This study proposed to establish and evaluate a nomogram for predicting the overall survival (OS) and cancer-specific survival (CSS) of RCC patients with bone metastasis.Materials and Methods:RCC patients with bone metastasis between 2010 and 2015 were captured from the surveillance, epidemiology and end results (SEER) database. Univariate and multivariate cox regressions were performed to assess the effects of clinical variables on OS and CSS. The nomogram based on the Cox hazards regression model was developed. Concordance index (C-index) and calibration curve were performed to evaluate the accuracy of nomogram models, receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were conducted to assess the predict performance.Results:A total of 2.471 eligible patients were enrolled in this study. The patients were assigned to primary (n=1.672) and validation (n=799) cohorts randomly. The 1-, 2-, and 3-year OS and CSS nomogram models were constructed based on age at diagnosis, sex, marital status, pathological grade, T-stage, N-stage, brain/liver/lung metastasis, surgery, radiotherapy and chemotherapy. The c for OS and CSS prediction was 0.730 (95% confidence interval [CI]: 0.719-0.741) and 0.714 (95%CI:0.702-0.726). The calibration curves showed significant agreement between nomogram models and actual observations. ROC and DCA indicated nomograms had better predict performance.Conclusions:The nomograms for predicting prognosis provided an accurate prediction of OS and CSS in RCC patients with bone metastasis, and contributed clinicians to optimize individualized treatment plans.
Highlights
Renal cell carcinoma (RCC) arises from abnormal differentiation of renal tubular epithelial cells [1]
This study evaluated data from the surveillance, epidemiology and end results (SEER) database [11], further investigated the factors affecting the prognosis of RCC patients with bone metastasis, and applied the obtained results to the construction of nomograms
Patients baseline characteristics There were 2.471 eligible RCC patients with bone metastasis enrolled in the statistical analysis
Summary
Renal cell carcinoma (RCC) arises from abnormal differentiation of renal tubular epithelial cells [1]. There were studies found that the prognosis of RCC patients with bone metastasis is closely related to age, TNM stage, other organ metastasis, whether receive targeted treatment [7, 8]. These predictions have not been validated effectively due to the rarity of the disease and there is still a lack of a predictive model that calculates different variables simultaneously. Nomogram has been regarded as a reliable model for predicting tumor prognosis considering the unique calculation method [9, 10] This provides a new method for prognostic analysis of RCC patients with bone metastasis. Our work will establish the nomogram predicting the prognosis of RCC patients with bone metastasis to assist clinicians in developing individualized treatment plans
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