Predictor Of Survival In Patients Research Articles

Accuracy of Preoperative Scoring System in Prediction of Postoperative Survival in Patients with Metastatic Bone Disease: A Systematic Review and Meta-Analysis

Abstract Background Management of patients with metastatic bone disease for which there is risk of pathological fracture remains a clinical challenge. Surgeries performed in cancer patients are procedures at a high risk of thromboembolic and infectious complications. Expected survival is the most important factor to determine the treatment modality. This study evaluated preoperative different survival scores in metastatic bone disease surgery. Methods An electronic search of medical literature was conducted through MEDLINE (accessed via Ovid), EMBASE (accessed via Ovid), and PubMed. We performed a systematic review for studies involving prognostic scores that assessed the survival rates of patients with bone metastases. Further, we conducted a meta-analysis including studies that measured the sensitivity and specificity of the Tokuhashi and Tomita score in predicting 6- month survival rates for spinal metastases. Results A total of 68 studies were included in our study; of them, 35 studies were included in the meta-analysis. Sensitivities ranged from 27 to 92% for the Tokuhashi score and from 76 to 99% for the Tomita score, and specificities ranged from 44 to 96% for the Tokuhashi score and from 1 to 44% for the Tomita score. The pooled DOR was 6.04 (95 % CI, 3.96– 9.21; Tau-squared= 0.90; I2= 86%) for the Tokuhashi score and 1.34 (95 % CI, 0.67–2.67; Tau-squared = 1.02; I2= 85%) for the Tomita score. The SORG Nomogram, developed in a large surgical cohort, showed good discrimination on 3-month and 1-year survival, good calibration and was superior in direct comparison with low risk of bias and low concern regarding applicability. PATHFx 3.0, 2013-SPRING and potentially Optimodel were found to be the best models in terms of performance in predicting survival for surgery for extremity metastasis. Conclusion Regarding spinal metastases, the SORG Nomogram and machine learning algorithms showed better performance in survival prediction for surgery. Regarding extremity metastases, we found PATHFx 3.0, 2013-SPRING and Optimodel to be the best models in terms of performance. Although Tokuhashi score was more accurate than Tomita score slightly, both showed low accuracy to predict 6 months residual survival.

A convenient calf proportion index calculator for survival prediction in overweight and obese patients with cancer

A convenient calf proportion index calculator for survival prediction in overweight and obese patients with cancer

Machine learning-based analysis identifies a 13-gene prognostic signature to improve the clinical outcomes of colorectal cancer.

Colorectal cancer (CRC) is a common intestinal malignancy worldwide, posing a serious threat to public health. Due to its high heterogeneity, prognosis and drug response of different CRC patients vary widely, limiting the effectiveness of traditional treatment. Therefore, this study aims to construct a novel CRC prognostic signature using machine learning algorithms to assist in making informed clinical decisions and improving treatment outcomes. Gene expression matrix and clinical information of CRC patients were obtained from the The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Then, genes with prognostic value were identified through univariate Cox regression analysis. Next, nine machine learning algorithms, including least absolute shrinkage and selection operator (LASSO), gradient boosting machine (GBM), CoxBoost, plsRcox, Ridge, Enet, StepCox, SuperPC and survivalSVM were integrated to form 97 combinations, which was employed to screen the best strategy for building a prognostic model based on the average C-index in the three CRC cohorts. Kaplan Meier survival analysis, receiver operating curve (ROC) analysis and multivariate regression analysis were conducted to assess the predictive performance of the constructed signature. Furthermore, the CIBERSORT and ESTIMATE algorithms were utilized to quantify the infiltration level of immune cells. Besides, a nomogram were developed to predict 1-, 2-, and 3-year overall survival (OS) probabilities for individual patient. A prognostic signature consisting of 13 genes was developed utilizing LASSO Cox regression and GBM methods. Across both the training and validation datasets, the performance evaluation consistently indicated the signature's capacity to accurately predict the prognosis of CRC patients. Especially, compared with 30 published signatures, the 13-gene model exhibited dramatically superior predictive power. Even within clinical subgroups, it could still precisely stratify the prognosis. Functional analysis revealed a robust association between the signature and the immune status as well as chemotherapy response in CRC patients. Furthermore, a nomogram was created based on the signature-derived risk score, which demonstrated a strong predictive ability for OS in CRC patients. The 13-gene prognostic signature is expected to be a valuable tool for risk stratification, survival prediction, and treatment evaluation of patients with CRC.

Decoding the immune microenvironment: unveiling CD8 + T cell-related biomarkers and developing a prognostic signature for personalized glioma treatment

BackgroundGliomas are aggressive brain tumors with poor prognosis. Understanding the tumor immune microenvironment (TIME) in gliomas is essential for developing effective immunotherapies. This study aimed to identify TIME-related biomarkers in glioma using bioinformatic analysis of RNA-seq data.MethodsIn this study, we employed weighted gene co-expression network analysis (WGCNA) on bulk RNA-seq data to identify TIME-related genes. To identify prognostic genes, we performed univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Based on these genes, we constructed a prognostic signature and delineated risk groups. To validate the prognostic signature, external validation was conducted.ResultsCD8 + T cell infiltration was strongly correlated with glioma patient prognosis. We identified 115 CD8 + T cell-related genes through integrative analysis of bulk-seq data. CDCA5, KIF11, and KIF4A were found to be significant immune-related genes (IRGs) associated with overall survival in glioma patients and served as independent prognostic factors. We developed a prognostic nomogram that incorporated these genes, age, gender, and grade, providing a reliable tool for clinicians to predict patient survival probabilities. The nomogram’s predictions were supported by calibration plots, further validating its accuracy.ConclusionIn conclusion, our study identifies CD8 + T cell infiltration as a strong predictor of glioma patient outcomes and highlights the prognostic value of genes. The developed prognostic nomogram, incorporating these genes along with clinical factors, provides a reliable tool for predicting patient survival probabilities and has important implications for personalized treatment decisions in glioma.

AI-Assisted Survival Prediction in Colorectal Cancer: A Clinical Decision Support Tool

Purpose: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Accurate survival prediction is crucial for advanced-stage patients to optimize treatment strategies and improve clinical outcomes. This study aimed to develop an artificial intelligence-assisted clinical decision support system (CDSS) for survival prediction in CRC patients using clinical and genomic data from the Cancer Genome Atlas Colon Adenocarcinoma Collection (TCGA-COAD) dataset. Methods: Machine learning algorithms, including C4.5 Decision Tree, Support Vector Machines (SVM), Random Forest, and Naive Bayes, were employed to create survival prediction models. Clinical parameters and genomic data from key pathways, such as glycolysis/gluconeogenesis and mTORC1, were integrated into the models. The models were evaluated based on accuracy and performance. Results: The Random Forest algorithm achieved the highest accuracy (82.3%) when only clinical parameters were used. When clinical data were combined with gene expression data, the model’s accuracy increased further. The resulting models were incorporated into a user-friendly web interface, SurvCOCA, for clinical use. Conclusions: This study demonstrates the potential of AI-based tools to improve prognosis predictions in CRC patients. Further research is needed, with larger datasets and additional machine learning algorithms, to enhance clinical decision-making and optimize treatment strategies.

Development and validation of a deep learning-based survival prediction model for pediatric glioma patients: A retrospective study using the SEER database and Chinese data

ObjectiveDevelop a time-dependent deep learning model to accurately predict the prognosis of pediatric glioma patients, which can assist clinicians in making precise treatment decisions and reducing patient risk. Study designThe study involved pediatric glioma patients from the Surveillance, Epidemiology, and End Results (SEER) Registry (2000–2018) and Tangdu Hospital in China (2010–2018) within specific time frames. For training, we selected two neural network-based algorithms (DeepSurv, neural multi-task logistic regression [N-MTLR]) and one ensemble learning-based algorithm (random survival forest [RSF]). Additionally, a multivariable Cox proportional hazard (CoxPH) model was developed for comparison purposes. The SEER dataset was randomly divided into 80 % for training and 20 % for testing, while the Tangdu Hospital dataset served as an external validation cohort. Super-parameters were fine-tuned through 1000 repeated random searches and 5-fold cross-validation on the training cohort. Model performance was assessed using the concordance index (C-index), Brier score, and Integrated Brier Score (IBS). Furthermore, the accuracy of predicting survival at 1, 3, and 5 years was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and the area under the ROC curves (AUC). The generalization ability of the model was assessed using the C-index of the Tangdu Hospital data, ROC curves for 1, 3, and 5 years, and AUC values. Lastly, decision curve analysis (DCA) curves for 1, 3, and 5-year time frames are provided to assess the net benefits across different models. ResultsA total of 9532 patients with pediatric glioma were included in this study, comprising 9274 patients from the SEER database and 258 patients from Tangdu Hospital in China. The average age at diagnosis was 9.4 ± 6.2 years, and the average survival time was 96 ± 66 months. Through comprehensive performance comparison, the DeepSurv model demonstrated the highest effectiveness, with a C-index of 0.881 on the training cohort. Furthermore, it exhibited excellent accuracy in predicting the 1-year, 3-year, and 5-year survival rates (AUC: 0.903–0.939). Notably, the DeepSurv model also achieved remarkable performance and accuracy on the Chinese dataset (C-index: 0.782, AUC: 0.761–0.852). Comprehensive analysis of DeepSurv, N-MTLR, and RSF revealed that tumor stage, radiotherapy, histological type, tumor size, chemotherapy, age, and surgical method are all significant factors influencing the prognosis of pediatric glioma. Finally, an online version of the pediatric glioma survival predictor based on the DeepSurv model has been established and can be accessed through https://pediatricglioma-tangdu.streamlit.app. ConclusionsThe DeepSurv model exhibits exceptional efficacy in predicting the survival of pediatric glioma patients, demonstrating strong performance in discrimination, calibration, stability, and generalization. By utilizing the online version of the pediatric glioma survival predictor, which is based on the DeepSurv model, clinicians can accurately predict patient survival and offer personalized treatment options.

Understanding m6A changes in chromophobe renal cell carcinoma and predicting patient outcomes survival

N6-methyladenosine (m6A) is a prevalent mRNA modification known for its implications in various cancer types, yet its role in chromophobe renal cell carcinoma (chRCC) remains largely unexplored. In this study, we performed m6A-SEAL-seq and RNA-seq analyses on tissues from three chRCC subjects, aiming to uncover m6A alterations in chRCC. Our findings revealed reduced expression levels of four m6A regulators in chRCC tissues and highlighted differences in m6A levels compared to normal tissues. Furthermore, we identified specific genes and cancer-related pathways affected by these differences, including notable candidates like NOTCH1 and FGFR1, implicated in chRCC development. Additionally, we developed a predictive model based on the expression level of m6A associated genes, demonstrating promising prognostic capabilities for patient survival prediction. Overall, our study provides valuable insights into the role of m6A in chRCC and its potential as a prognostic indicator.

Determinants of Prognosis in Head and Neck Cutaneous Squamous Cell Carcinoma With Nodal Metastases

The eighth edition tumor, node, metastasis (TNM) staging for head and neck cutaneous squamous cell carcinoma (HNcSCC) is a poor predictor of survival in patients with lymph node metastases, possibly due to the inclusion of extranodal extension (ENE). To identify the key determinants of prognosis in patients with nodal metastatic HNcSCC and analyze the association of ENE with TNM stage and investigate for prognostic heterogeneity in ENE-positive disease. This retrospective, multicenter cohort study was conducted at 4 Australian tertiary referral centers using prospectively collected data in patients treated between 1980 and 2017 with a median (IQR) follow-up of 3.2 (3.9) years. The study population included 1309 consecutive patients with HNcSCC that was metastatic to parotid and/or cervical nodes. After excluding cases with perioperative mortality, missing data, or follow-up, the final study population included 1151 patients. Curative intent surgery ± adjuvant radiotherapy. Differences in locoregional control (LRC), disease-specific survival (DSS), and overall survival were determined using Cox regression analysis. Among 1151 patients, 976 (84.8%) were male and 175 (15.2%) female, with a median age of 73.3 years (range, 18-100 years). On multivariable analysis, immunosuppression (hazard ratio [HR], 2.48; 95% CI, 1.64-3.74), perineural invasion (HR, 1.69; 95% CI, 1.25-2.30), ENE (HR, 1.53; 95% CI, 0.95-2.44), size (>3-6 cm vs ≤3 cm [HR, 1.41; 95% CI, 1.03-1.93]; >6 cm vs ≤3 cm [HR, 5.01; 95% CI, 2.98-8.42]), and number of nodal metastases (3-4 vs 1-2 [HR, 1.54; 95% CI, 1.01-2.34]; ≥5 vs 1-2 [HR, 2.86; 95% CI, 1.99-4.11]) were associated with DSS. Similar results were found for LRC and overall survival. More than 90% of the population was categorized as TNM stage IV, with 32% attributable to ENE. In the ENE-positive subset (n = 860), DSS ranged from 8% to 88% based on stratification using other clinicopathological factors. The study results suggest that immunosuppression, perineural invasion, ENE, and size and number of nodal metastases are associated with reduced survival and LRC in HNcSCC with nodal metastases. The inclusion of ENE in HNcSCC staging needs to be reassessed, as it ascribes excessive importance to ENE and upstages most patients to TNM stage IV, despite many having a high chance of cure.

Dual antiplatelet including clopidogrel and aspirin, cardiac MRI, and speckle tracking echocardiography parameters in ST-elevation myocardial infarction patients

Coronary artery disease is the medical term for atherosclerotic coronary disease, which causes the coronary arteries to constrict and inadequately provide blood to the heart. ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, & unstable angina are the three conditions that comprise acute coronary syndromes. Studied cases with STEMI have been advised to take several drugs in addition to early reperfusion treatment, such as antiplatelet & anticoagulant medications. The goal of antiplatelet medications is to stop platelets from aggregating together. Oral dual antiplatelet medication, which combines lifetime aspirin with an oral P2Y12 receptor inhibitor, is the main antiplatelet therapy in STEMI. Aspirin ought to be administered to all studied cases immediately following diagnosis, and a low dose of treatment should be continued indefinitely. Heart mortality and severe adverse cardiac events are strongly and independently correlated with the presence & size of scarred tissue seen by cardiac MRI. Scar transmurality measured by cardiac MRI in studied cases with healed infarcts & ventricular dysfunction predicts patient survival and functional recovery following revascularization. Patients with heart illnesses that have a history of ST-segment elevation myocardial infarction may be at risk for unfavorable results based on echocardiographic evaluation of cardiac structure & function. Because speckle tracking echocardiography (STE) is quick and simple to do, it can be used in acute settings as well. It can be used for further risk stratification following revascularization, before invasive coronary angiography, or in cases when a diagnosis is unclear, if available.

Comprehensive strain assessment and mortality after acute myocardial infarction: a retrospective observational study based on the Essen Coronary Artery Disease registry

Background and aimsCurrent ESC guidelines on the management of patients after acute myocardial infarction only include the evaluation of left ventricular (LV) function by assessment of the ejection fraction in...

Anoikis-related genes in breast cancer patients: reliable biomarker of prognosis

BackgroundBreast cancer (BC) is the most common cancer in women, and its progression is closely related to the phenomenon of anoikis. Anoikis, the specific programmed death resulting from a lack of contact between cells and the extracellular matrix, has recently been recognized as playing a critical role in tumor initiation, maintenance, and treatment. The ability of cancer cells to resist anoikis leads to cancer progression and metastatic colonization. However, the impact of anoikis on the prognosis of BC patients remains unclear.MethodThis study utilized data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to collect transcriptome and clinical data of BC patients. Anoikis-related genes (ARGs) were classified into subtypes A and B through consensus clustering. Subsequently, survival prognosis analysis, immune cell infiltration analysis, and functional enrichment analysis were performed for both subtypes. Using the Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, a set of 10 ARGs related to prognosis was identified. Immune cell infiltration and tumor microenvironment analyses were conducted on these 10 ARGs to develop a prognostic model. Furthermore, single-cell data analysis and real-time polymerase chain reaction (RT-PCR) analysis were employed to study the expression of the 10 identified prognostic ARGs in BC cells.ResultsOne hundred thirty-five ARGs were identified as differentially expressed genes in the TCGA and GEO databases, with 42 of them associated with the survival prognosis of BC patients. Analyses involving Principal Component Analysis (PCA), t-Distributed Stochastic Neighbor Embedding (t-SNE), and Uniform Manifold Approximation and Projection (UMAP) revealed distinct expression patterns of ARGs between types A and B. Patients in type A exhibited worse survival prognosis and lower immune cell infiltration compared to type B. Subsequent analyses identified 10 key ARGs (YAP1, PIK3R1, BAK1, PHLDA2, EDA2R, LAMB3, CD24, SLC2A1, CDC25C, and SLC39A6) relevant to BC prognosis. Kaplan–Meier analysis indicated that high-risk patients based on these ARGs had a poorer BC prognosis. Additionally, Cox regression analysis established gender, age, T (tumor), N (nodes), and risk score as predictive factors in a nomogram model for BC. The model demonstrated diagnostic value for BC patients at 1, 3, and 5 years. Decision curve analysis (DCA) verified the risk score as a reliable predictor of BC patient survival rates. Moreover, RT-PCR results confirmed differential expressions of YAP1, PIK3R1, BAK1, PHLDA2, CD24, SLC2A1, and CDC25C in BC cells, with SLC39A6, EDA2R, and LAMB3 showing low expression levels.ConclusionARGs markers can be used as BC biomarkers for risk stratification and survival prediction in BC patients. Besides, ARGs can be used as stratification factors for individualized and precise treatment of BC patients.

Identification of telomere-related lncRNAs and immunological analysis in ovarian cancer.

Ovarian cancer (OC) is a global malignancy characterized by metastatic invasiveness and recurrence. Long non-coding RNAs (lncRNAs) and Telomeres are closely connected with several cancers, but their potential as practical prognostic markers in OC is less well-defined. Relevant mRNA and clinical data for OC were sourced from The Cancer Genome Atlas (TCGA) database. The telomere-related lncRNAs (TRLs) prognostic model was established by univariate/LASSO/multivariate regression analyses. The effectiveness of the TRLs model was evaluated and measured via the nomogram. Additionally, immune infiltration, tumor mutational load (TMB), and drug sensitivity were evaluated. We validated the expression levels of prognostic genes. Subsequently, PTPRD-AS1 knockdown was utilized to perform the CCK8 assay, colony formation assay, transwell assay, and wound healing assay of CAOV3 cells. A six-TRLs prognostic model (PTPRD-AS1, SPAG5-AS1, CHRM3-AS2, AC074286.1, FAM27E3, and AC018647.3) was established, which can effectively predict patient survival rates and was successfully validated using external datasets. According to the nomogram, the model could effectively predict prognosis. Furthermore, we detected the levels of regulatory T cells and M2 macrophages were comparatively higher in the high-risk TRLs group, but the levels of activated CD8 T cells and monocytes were the opposite. Finally, the low-risk group was more sensitive to anti-cancer drugs. The mRNA levels of PTPRD-AS1, SPAG5-AS1, FAM27E3, and AC018647.3 were significantly over-expressed in OC cell lines (SKOV3, A2780, CAOV3) in comparison to normal IOSE-80 cells. AC074286.1 were over-expressed in A2780 and CAOV3 cells and CHRM3-AS2 only in A2780 cells. PTPRD-AS1 knockdown decreased the proliferation, cloning, and migration of CAOV3 cells. Our study identified potential biomarkers for the six-TRLs model related to the prognosis of OC.

Clinical significance of the modified Naples prognostic score in patients with stage II-III colon cancer undergoing curative resection: a retrospective study from the real world.

The Naples prognostic score (NPS) determined by the nutritional and inflammatory condition of an individual is attracting growing attention for predicting postoperative outcomes in a variety of malignancies. The study aimed to assess the clinical significance of a modified NPS (M-NPS) and establish and validate nomograms incorporating M-NPS in curative stage II-III colon cancer patients. We retrospectively analyzed 328 stage II-III colon cancer patients receiving radical surgical resection at our hospital from January 2011 to December 2016. Kaplan-Meier (KM) survival analysis and Cox regression analysis were executed for overall survival (OS) and cancer-specific survival (CSS). Independent predictive indicators were applied to develop nomograms. The model's performance was evaluated using many different methods. Of a total of 328 cases, 153 cases were in group 0, 145 in group 1, and 30 in group 2. In terms of OS or CSS, there were obvious differences between groups 0 and 1, and between groups 0 and 2. Age, obstruction, N stage, gross tumor type, and M-NPS group were independent prognostic indicators for OS, while obstruction, gross tumor type, M-NPS group, and N stage were independent predictive parameters for CSS. Furthermore, the training and validation sets were randomly allocated among a cohort of 328 patients. OS and CSS prediction nomograms were developed. In the training and validation cohort, the C-index and ROC analysis showed good discrimination, calibration curves exhibited an excellent level of consistency between model-predicted survival and actual survival outcomes, and DCA curves demonstrated good clinical performance. M-NPS is a reliable survival predictor in patients with curative stage II-III colon cancer. Nomograms incorporating M-NPS for OS and CSS have good predictive performance and clinical utility.

Tumor burden with AFP improves survival prediction for TACE-treated patients with HCC: An international observational study☆

Background & aimsCurrent prognostic models for patients with HCC undergoing transarterial chemoembolization (TACE) are not extensively validated and widely accepted. We aimed to develop and validate a continuous model incorporating tumor burden and biology for individual survival prediction and risk stratification. MethodsOverall, 4,377 treatment-naïve recommended TACE candidates from 39 centres in 5 countries were enrolled and divided into a training, internal validation, and two external validation datasets. The novel model was developed using a Cox multivariable regression analysis and compared with our original 6-and-12 model (the largest tumor size [ts, centimetres] + tumor number [tn]) and other available models in terms of predictive accuracy. ResultsThe proposed model named the ‘6-and-12 model 2.0’ was generated as ‘ts + tn + 1.5 × log10 alpha-fetoprotein [AFP])’, showed good discrimination (C-index 0.674) and calibration (Hosmer-Lemeshow test p=0.147), and outperformed current existing models. An easy-to-use stratification was proposed according to the different AFP levels (≤100, 100–400, 400–2,000, 2,000–10,000, 10,000–40,000, and >40,000 ng/ml) along with the corresponding tumor burden cut-offs (8/14, 7/13, 6/12, 5/11, 4/10, and any tumor burden), i.e. if the AFP level was 400–2,000 ng/ml, the stratification should be low-(≤6)/intermediate-(6-12)/high-risk (>12) strata. Hence, it could divide the patients into three distinct risk categories with a median overall survival of 45.0 (95% confidence interval [CI], 40.1–49.9), 30.0 (95% CI, 26.1–33.9), and 15.4 (95% CI, 13.4–17.4) months (p<0.001) from low-risk to high-risk strata, respectively. These findings were confirmed in validation and subgroup analyses. ConclusionsThe 6-and-12 model 2.0 significantly improved individual outcome prediction and better stratified the recommended TACE candidates, which could be used in clinical practice, as well as trial design.

A modified GLIM criteria-based nomogram for the survival prediction of gastric cancer patients undergoing surgical resection

BackgroundThis study aimed to develop a comprehensive model based on five GLIM variables to predict the individual survival and provide more appropriate patient counseling.MethodsThis retrospective cohort study included 301 gastric cancer (GC) patients undergoing radical resection. C-reactive protein (CRP) as an inflammatory marker was included in GLIM criteria and a nomogram for predicting 5-year overall survival (OS) in GC patients was established. The Bootstrap repeated sampling for 1000 times was used for internal validation.ResultsOf the total 301 patients, 20 (6.64%) died within 5 years. CRP improved the sensitivity and accuracy of the survival prediction model (AUC = 0.782, 0.694 to 0.869 for the model without CRP; AUC = 0.880, 0.809 to 0.950 for the model adding CRP). Besides, a GLIM-based nomogram was established with an AUC of 0.889. The C-index for predicting OS was 0.878 (95% CI: 0.823 to 0.934), and the calibration curve fitted well. Decision curve analysis (DCA) showed the clinical utility of the nomogram based on GLIM.ConclusionThe addition of CRP improved the sensitivity and accuracy of the survival prediction model. The 5-year survival probability of GC patients undergoing radical resection can be reliably predicted by the nomogram presented in this study.

Integrated MRI radiomics, tumor microenvironment, and clinical risk factors for improving survival prediction in patients with glioblastomas.

To construct acomprehensive model for predicting the prognosis of patients with glioblastoma (GB) using aradiomics method and integrating clinical risk factors, tumor microenvironment (TME), and imaging characteristics. In this retrospective study, we included 148 patients (85males and 63females; median age 53years) with isocitrate dehydrogenase-wildtype GB between January 2016 and April 2022. Patients were randomly divided into the training (n = 104) and test (n = 44) sets. The best feature combination related to GB overall survival (OS) was selected using LASSO Cox regression analyses. Clinical, radiomics, clinical-radiomics, clinical-TME, and clinical-radiomics-TME models were established. The models' concordance index (C-index) was evaluated. The survival curve was drawn using the Kaplan-Meier method, and the prognostic stratification ability of the model was tested. LASSO Cox analyses were used to screen the factors related to OS in patients with GB, including MGMT (hazard ratio [HR] = 0.642; 95% CI 0.414-0.997; P = 0.046), TERT (HR = 1.755; 95% CI 1.095-2.813; P = 0.019), peritumoral edema (HR = 1.013; 95% CI 0.999-1.027; P = 0.049), tumor purity (TP; HR = 0.982; 95% CI 0.964-1.000; P = 0.054), CD163 + tumor-associated macrophages (TAMs; HR = 1.049; 95% CI 1.021-1.078; P < 0.001), CD68 + TAMs (HR = 1.055; 95% CI 1.018-1.093; P = 0.004), and the six radiomics features. The clinical-radiomics-TME model had the best survival prediction ability, the C‑index was 0.768 (0.717-0.819). The AUC of 1‑, 2‑, and 3‑year OS prediction in the test set was 0.842, 0.844, and 0.795, respectively. The clinical-radiomics-TME model is the most effective for predicting the survival of patients with GB. Radiomics features, TP, and TAMs play important roles in the prognostic model.

Developing survival prediction models in colorectal cancer using epigenome-wide DNA methylation data from whole blood

While genome-wide association studies are valuable in identifying CRC survival predictors, the benefit of adding blood DNA methylation (blood-DNAm) to clinical features, including the TNM system, remains unclear. In a multi-site population-based patient cohort study of 2116 CRC patients with baseline blood-DNAm, we analyzed survival predictions using eXtreme Gradient Boosting with a 5-fold nested leave-sites-out cross-validation across four groups: traditional and comprehensive clinical features, blood-DNAm, and their combination. Model performance was assessed using time-dependent ROC curves and calibrations. During a median follow-up of 10.3 years, 1166 patients died. Although blood-DNAm-based predictive signatures achieved moderate performances, predictive signatures based on clinical features outperformed blood-DNAm signatures. The inclusion of blood-DNAm did not improve survival prediction over clinical features. M1 stage, age at blood collection, and N2 stage were the top contributors. Despite some prognostic value, incorporating blood DNA methylation did not enhance survival prediction of CRC patients beyond clinical features.

Radiogenomics based survival prediction of small-sample glioblastoma patients by multi-task DFFSP model.

In this paper, the multi-task dense-feature-fusion survival prediction (DFFSP) model is proposed to predict the three-year survival for glioblastoma (GBM) patients based on radiogenomics data. The contrast-enhanced T1-weighted (T1w) image, T2-weighted (T2w) image and copy number variation (CNV) is used as the input of the three branches of the DFFSP model. This model uses two image extraction modules consisting of residual blocks and one dense feature fusion module to make multi-scale fusion of T1w and T2w image features as backbone. Also, a gene feature extraction module is used to adaptively weight CNV fragments. Besides, a transfer learning module is introduced to solve the small sample problem and an image reconstruction module is adopted to make the model anatomy-aware under a multi-task framework. 256 sample pairs (T1w and corresponding T2w MRI slices) and 187 CNVs of 74 patients were used. The experimental results show that the proposed model can predict the three-year survival of GBM patients with the accuracy of 89.1 %, which is improved by 3.2 and 4.7 % compared with the model without genes and the model using last fusion strategy, respectively. This model could also classify the patients into high-risk and low-risk groups, which will effectively assist doctors in diagnosing GBM patients.

Prognostic nomogram combining 18F-FDG PET/CT radiomics and clinical data for stage III NSCLC survival prediction

The aim of this study was to establish and validate the precision of a novel radiomics approach that integrates 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)-computed tomography (CT) scan data with clinical information to improve the prognostication of survival rates in patients diagnosed with stage III Non-Small Cell Lung Cancer (NSCLC) who are not candidates for surgery. We evaluated pretreatment 18F-FDG PET-CT scans from 156 individuals diagnosed with stage III inoperable NSCLC at Shandong Cancer Hospital. These individuals were divided into two groups: a training set comprising 110 patients and an internal validation set consisting of 46 patients. By employing random forest classifier and cox proportional hazards model , we identified and utilized relevant features to create predictive models and a nomogram. The effectiveness of these models was assessed through the use of the receiver operating characteristics(ROC) curves, Kaplan–Meier (KM) curves, and the application of the nomogram. Our findings showed that the combined model, which integrates both clinical and radiomic data, outperformed those based solely on clinical or radiomic features in predicting 3-year overall survival(OS). Furthermore, calibration plots revealed a high level of agreement between predicted and actual survival times. The research successfully established a predictive radiomics model that integrates 18F-FDG PET/CT imaging with clinical indicators to enhance survival predictions for patients with stage III inoperable NSCLC.

933P Prediction of survival in patients with head and neck merkel cell carcinoma: Statistical and machine-learning approaches

933P Prediction of survival in patients with head and neck merkel cell carcinoma: Statistical and machine-learning approaches