Chen Weiming,Bai Jianxi,Zhang Bing,et al.Establishment and validation of a survival prediction model for children with neuroblastoma[J].Journal of Clinical Pediatric Surgery,2025,(03):243-249.[doi:10.3760/cma.j.cn101785-202207009-008]
Establishment and validation of a survival prediction model for children with neuroblastoma
- Keywords:
- Neuroblastoma; Nomogram; Prognosis; Surgical Procedures; Operative; Child
- Abstract:
- Objective To establish and validate a clinical prediction model assessing the survival of children with neuroblastoma (NB). Methods The relevant clinical data were collected from NB children between 2000 and 2019 from the database of Surveillance,Epidemiology and End Results (SEER).The primary cohort was randomized into two sets of training (n=987) and validation (n=493).The prognostic effects of variables were examined with a Cox proportional hazard model.Nomograms were established for estimating 1/3/5-year overall survival (OS) based upon Cox regression model.Concordance index (C-index),area under time-dependent receiver operating characteristics curve (AUC-ROC),calibration plotting and decision-curve analysis (DCA) were utilized for evaluating the model. Results The results of the multivariate Cox regression analysis indicated that 1-5 years (HR=3.595,95%CI:2.122-6.091) or ≥5 years (HR=4.556,95%CI:2.566-8.091),tumour length ≥7.5 cm (HR=1.934,95%CI:1.347-2.777),tumour located in the adrenal and retroperitoneal (HR=1.520,95%CI:1.029-2.247),tumour metastasis (HR=5.263,95%CI:2.146-12.907),and not receiving surgical treatment (HR=1.866,95%CI:1.225-2.833) were identified as independent risk factors for poor prognosis in children with neuroblastoma.A nomogram was constructed based on the aforementioned independent prognostic factors for the purpose of overall survival prediction at 1/3/5-year in children with neuroblastoma.C-index of prediction model in training and validation sets were 0.803 and 0.785 respectively.AUC of ROC curves in training set at 1/3/5-year overall survival were 0.782,0.829 and 0.842 respectively.Validation set revealed that AUC of ROC curve of 1/3/5-year overall survival were 0.748,0.807 and 0.855 respectively.DCA indicated that using the nomogram for predicting the prognosis of NB children was more beneficial at a prediction probability threshold of (0.1-0.6). Conclusions Nomogram is a reliable and powerful tool for distinguishing and predicting the survival of NB children,thus assisting clinicians in making clinical decisions.
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Memo
收稿日期:2022-7-6。
基金项目:福建省自然科学基金(2023J011300);福建医科大学启航基金(2021QH1168)
通讯作者:方一凡,Email:fyf0599@163.com