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- Title
Development and external validation of nomograms to predict the risk of skeletal metastasis at the time of diagnosis and skeletal metastasis-free survival in nasopharyngeal carcinoma.
- Authors
Lin Yang; Liangping Xia; Yan Wang; Shasha He; Haiyang Chen; Shaobo Liang; Peijian Peng; Shaodong Hong; Yong Chen; Yang, Lin; Xia, Liangping; Wang, Yan; He, Shasha; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Hong, Shaodong; Chen, Yong
- Abstract
<bold>Background: </bold>The skeletal system is the most common site of distant metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal metastasis at initial diagnosis (SMAD) and skeletal metastasis-free survival (SMFS) in NPC.<bold>Methods: </bold>A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 2496 patients without skeletal metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions.<bold>Results: </bold>Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P < 0.001). The SMFS nomogram had significantly higher c-index values in the training and validation sets than the TNM staging system (P < 0.001 and P = 0.005, respectively). Three proposed risk stratification groups were created using the nomograms, and enabled significant discrimination of SMFS for each risk group.<bold>Conclusion: </bold>The prognostic nomograms established in this study enable accurate stratification of distinct risk groups for skeletal metastasis, which may improve counseling and facilitate individualized management of patients with NPC.
- Subjects
NOMOGRAPHY (Mathematics); PROPHECY; BONE metastasis; DIAGNOSIS; COMPUTED tomography; EPIDEMIOLOGY of cancer; CANCER-related mortality; CANCER treatment; BONE tumors; CANCER; DEOXY sugars; PROGNOSIS; NASOPHARYNX tumors; RADIOPHARMACEUTICALS; RESEARCH evaluation; TUMOR classification; RETROSPECTIVE studies; STATISTICAL models; KAPLAN-Meier estimator; TUMOR treatment
- Publication
BMC Cancer, 2017, Vol 17, p1
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-017-3630-9