成人髓母细胞瘤的临床特征和总体生存预后列线图:基于SEER数据库分析  

Clinical characteristics and overall survival prognostic nomogram for adult medulloblastomas:A surveillance,epidemiology,and end results population-based analysis

作　　者：贺真伟 张桐 王子德 马贵斌 李祥 HE Zhenwei;ZHANG Tong;WANG Zide;MA Guibin;LI Xiang(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院,江苏徐州221000

出　　处：《中国实用神经疾病杂志》2023年第10期1221-1226,共6页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金(编号:82002632)。

摘　　要：目的基于监测、流行病学和最终结果(SEER)数据库调查所有成人髓母细胞瘤(MB)患者的人口统计学、预后和预后因素,建立临床预后模型预测成人MB患者的生存时间。方法从SEER数据库选取1973—2019年确诊的病例,通过单变量和多变量分析,评估年龄、诊断年份、性别、人种、肿瘤部位、肿瘤大小、病理类型、总分期、手术方式、放疗和化疗的使用对总生存率的影响。构建并验证预测成人MB的1、3和5 a生存率列线图。结果数据清理后,纳入784例成人MB患者。最后一次随访时患者的平均生存时间为96个月。在多变量分析中,年龄、诊断年份、肿瘤部位、组织学类型和放疗均显示与2组患者的生存率独立相关。建立临床列线图,列线图的C-指数为0.6285(0.5944~0.6626)。1 a、3 a和5 a的校准曲线显示,列线图预测与实际观察结果之间具有良好的一致性,列线图的内部验证表明该预测方式可区分高危与低危病人。结论建立预测成人MB患者总体生存率的列线图可帮助临床准确预测患者的预后并进行进一步的治疗。Objective To examine the demographic,prognostic and clinical factors of adult medulloblasto⁃ma(MB)patients using the Surveillance,Epidemiology,and End Results(SEER)database and to develop a prog⁃nostic model for predicting their survival outcomes.Methods We selected the cases diagnosed between 1973 and 2019 from the SEER database.We assessed the effects of age,year of diagnosis,gender,ethnicity,tumor site,tumor size,histological type,total score,surgical method,and radiotherapy and chemotherapy on overall survival(OS)by univariate and multivariate analysis.We constructed and validated nomograms for predicting 1-,3-,and 5-year OS for adult MB patients.Results After data cleaning,we included 784 adult MB patients.The mean sur⁃vival time at the last follow-up was 96 months.In multivariate analysis,age,year of diagnosis,tumor site,histologi⁃cal type,and radiotherapy were independent predictors of OS for both groups of patients.We established a clinical nomogram with a C-index of 0.6285(0.5944-0.6626).The calibration curves at 1,3,and 5 years showed good agreement between the nomogram prediction and the actual observed outcomes.The internal validation of the nomogram showed that it could discriminate high-risk from low-risk patients.Conclusion This study establishes a nomogram to predict the OS of adult MB patients,which can help clinicians accurately estimate their prognosis and plan further treatment.

关 键 词：髓母细胞瘤 成年人 SEER数据库 预后 影响因素 列线图 

分 类 号：R739.41[医药卫生—肿瘤]