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Development and validation of a prognostic nomogram for patients with malignant peritoneal mesothelioma
Xiaohan Wang1, RuiTing Liu1, Chunli Wang2
1Chengde Medical University, Chengde, China.
Background:
Malignant peritoneal mesothelioma(MPM) is a highly aggressive malignant tumor that originates from peritoneal mesothelial cells. Due to the rarity of MPM, there are few survival prediction models specifically for visualization of malignant peritoneal mesothelioma.
Objective:
This study aimed to develop a nomogram for the overall survival of MPM based on the Surveillance, Epidemiology, and End Results (SEER) database and the data of Cangzhou People's Hospital were used for external verification.
Methods:
Patients screened from the SEER database were divided into a training group and an internal verification group in a 7:3 ratio, with data from Cangzhou People's Hospital used as the external verification group. Cox proportional hazard regression was utilized to identify significant factors, and nomograms for 6-month, 12-month, and 18-month overall survival were developed. The performance of the nomogram was assessed using consistency index, calibration curve, and K-M curve.
Results:
Age, sex, histology, surgery, tumor size, chemotherapy, differentiated and the number of organ metastases were significant risk factors (p<0.05) and were included in the nomogram.The area under the subject worker curve at 6,12,18 months overall survival (AUC) was 0.782,0.784,0.766 for the training group, 0.804,0.791,0.796 for the internal verification group, 0.767,0.749,0.783 for the external verification group. The predicted correction curve was in good agreement with the observed results. The Kaplan-Meier curves of different risk groups showed significant differences.
Conclusion:
This study represents the first visual prognostic model of MPM and the initial incorporation of organ metastasis into MPM prognostic factors. The nomograph serves as a reliable tool for clinicians to personalize overall survival prediction and maximize patient benefits by identifying the most effective treatment.
Insights
This study developed the first visual prognostic model for malignant peritoneal mesothelioma (MPM), incorporating organ metastasis. The nomogram accurately predicts overall survival, aiding personalized treatment strategies for this rare cancer.
Area of Science:
- Oncology
- Medical Informatics
- Cancer Research
Background:
- Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer originating from peritoneal mesothelial cells.
- Limited survival prediction models exist for MPM, hindering effective patient management.
Purpose of the Study:
- To develop a visual prognostic nomogram for overall survival in MPM patients.
- To validate the nomogram using both internal and external datasets.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database for model development and internal validation.
- Employed Cox proportional hazard regression to identify significant prognostic factors.
- External validation was performed using data from Cangzhou People's Hospital.
Main Results:
- Identified age, sex, histology, surgery, tumor size, chemotherapy, differentiation, and organ metastasis as significant risk factors (p<0.05).
- The nomogram demonstrated good predictive performance with AUC values ranging from 0.766 to 0.804 across different time points and datasets.
- Calibration curves and Kaplan-Meier analyses confirmed the nomogram's accuracy and ability to differentiate risk groups.
Conclusions:
- This study presents the first visual prognostic model for MPM, incorporating organ metastasis as a novel factor.
- The developed nomogram is a reliable tool for clinicians to personalize survival predictions and optimize treatment strategies for MPM patients.
