A SEER-based nomogram accurately predicts prognosis in Ewing's sarcoma
Haibo Zhan1,2, Fengbo Mo1,2, Meisong Zhu1,2
1Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
Scientific Reports
|November 23, 2021
Summary
A new nomogram integrating age, tumor size, primary site, and metastasis stage accurately predicts survival for Ewing sarcoma patients. This tool offers improved risk assessment and survival prediction compared to the traditional TNM staging system.
Area of Science:
- Oncology
- Medical Statistics
Background:
- Ewing sarcoma is a rare but aggressive bone and soft tissue cancer primarily affecting children and adolescents.
- Despite advances, significant improvements in the 5-year survival rate for Ewing sarcoma remain elusive.
Purpose of the Study:
- To identify independent risk factors influencing Ewing sarcoma prognosis.
- To develop and validate a nomogram for predicting patient survival (overall and cancer-specific).
Main Methods:
- Utilized data from the Surveillance, Epidemiology, and End Results (SEER) program (2004-2015).
- Employed univariate and multivariate Cox regression analyses to identify prognostic factors.
- Constructed and validated a nomogram using training and validation cohorts, assessing predictive accuracy with ROC curves and C-indexes, and comparing it against the 7th TNM staging system.
Main Results:
- A nomogram integrating age, tumor size, primary site, N stage, and M stage was developed.
- The nomogram demonstrated superior predictive accuracy (C-indexes for OS and CSS: 0.744 and 0.743) compared to the 7th TNM stage (C-indexes: 0.695 and 0.698).
- Internal and external validation confirmed good consistency between predicted and observed survival values.
Conclusions:
- Age, tumor size, primary site, N stage, and M stage are significant independent prognostic factors for Ewing sarcoma.
- The developed nomogram provides a more accurate and reliable tool for risk stratification and survival prediction in Ewing sarcoma patients than the current TNM staging system.
