A Nomogram Predicting Recurrence and Guiding Adjuvant Radiation for Thymic Carcinoma After Resection
Yang Wang1, Liangliang Xu2, Tongxin Du1
1Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China.
Background:
Resection is an effective treatment for thymic carcinoma. We aimed to develop a nomogram for postoperative prediction of recurrence-free survival for patients with thymic carcinoma and guide adjuvant radiotherapy.
Methods:
A total of 198 patients who underwent surgery were divided into training cohort (n = 152) and validation cohort (n = 46). Clinicopathologic features and independent factors for postoperative recurrence were analyzed. A predictive nomogram was developed based on the prognostic factors. Discrimination and predictive accuracy of the model were measured using the concordance index (C-index), calibration curves, and validation study.
Results:
The overall 1-, 3-, and 5-year recurrence rate of 198 patients was 7.6%, 27.9%, and 39.9%, respectively. Independent predictors of recurrence-free survival on multivariate analysis were incorporated into the nomogram. Calibration curves for the probability of 1-, 3-, and 5-year recurrence-free survival fitted well. The C-index of the nomogram for predicting recurrence-free survival was 0.862 (95% confidence interval: 0.804 to 0.919). Internal validation supported the results optimally. Adjuvant radiotherapy was effective for patients with a total score greater than 208.
Conclusions:
Our nomogram for predicting recurrence-free survival had good performance. Adjuvant radiotherapy should be recommended for patients with a total score greater than 208.
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