Development and Validation of Predicting Nomograms for Craniopharyngioma: A Retrospective, Multiple-Center, Cohort Study
| Autor: | Longxiao Zhang, Zhe Li, Shengqi Zhao, Peizhu Hu, Fuyou Guo, Dengpan Song, Dingkang Xu, Xianzhi Liu, Yuchao Zuo, Qiang Gao, Shixiong Lei, Yan Hu, Fangbo Lin, Qingjie Wei, Mingchu Zhang, Mengzhao Feng, Chunxiao Ma |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty risk stratification nomogram 03 medical and health sciences 0302 clinical medicine Quality of life medicine Progression-free survival RC254-282 long-term surveillance Original Research Framingham Risk Score Receiver operating characteristic Proportional hazards model business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Nomogram online calculator neuropsychological status Oncology 030220 oncology & carcinogenesis Cohort Radiology business craniopharyngioma progression-free survival 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Frontiers in Oncology Frontiers in Oncology, Vol 11 (2021) |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2021.691288 |
| Popis: | Craniopharyngiomas (CPs) are benign tumors arising from the sellar region. However, little is known about their clinical features and long-term recurrence due to low morbidity and the lack of large cohort studies. Thus, we aimed to develop nomograms to accurately predict the extent of resection and tumor recurrence using clinical parameters. A total of 545 patients diagnosed with CP between 2009 and 2019 were examined: 381 in the development cohort and 164 in the validation cohort. Least absolute shrinkage and selection operator (LASSO) and Cox regression analyses were performed to establish two nomograms. Receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA) and Kaplan-Meier (KM) curves were used to evaluate their predictive performance and discriminative power, respectively, in the two cohorts. In addition, the EORTC QLQ-BN20 questionnaire was used to assess neuropsychological status in the follow-up. In the development cohort, the area under the curve (AUC) and C-index were 0.760 and 0.758, respectively, for predicting the extent of resection and 0.78 and 0.75, respectively, for predicting 3-year progression-free survival (PFS) and 5-year PFS. Additionally, the model had a predictive accuracy of 0.785. Both nomograms showed acceptable discrimination in the two cohorts. Moreover, DCA demonstrated excellent clinical benefits from the two nomograms. Finally, participants were classified into two distinct risk groups according to the risk score, and an online calculator was created for convenient clinical use. During long term follow-up, hypothyroidism (77.61%) and hypocortisolism (76.70%) were the most common endocrine dysfunction after surgery and significant deficits were observed concerning visual disorder, motor dysfunction and seizures in the recurrent groups. In particular, better quality of life was associated with gross total resection (GTR), postoperative radiation, anterior interhemispheric (AI) approach and transsphenoidal approach. To our knowledge, these are the first nomograms based on a very large cohort of patients with CP that show potential benefits for guiding treatment decisions and long-term surveillance. The current study demonstrated the online calculator serve as the practical tool for individual strategies based on the patient’s baseline characteristics to achieve a better prognosis. |
| Databáze: | OpenAIRE |
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