在直肠癌患者中开发和验证竞争性风险模型:基于SEER数据库
Ruobing Hu1, Xiuling Li1, Xiaomin Zhou2
1Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, No.7 Weiwu Road, Zhengzhou, 450003, Henan, China.
European journal of medical research
|September 22, 2023
概括
这项研究开发了一种使用竞争性风险模型的预测名录,以准确估计直肠癌死亡率. 该模型有助于临床医生为直肠癌患者做出更好的治疗和后续决策.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
背景情况:
- 结直肠癌是一种普遍存在的恶性瘤,死亡率很高.
- 准确预测死亡风险对于有效的患者管理至关重要.
研究的目的:
- 构建和验证直肠癌患者的时间特定死亡率的预测性名录.
- 将竞争风险模型的准确性与传统的生存分析进行比较.
主要方法:
- 利用了23680名直肠癌患者的监测,流行病学和最终结果 (SEER) 数据库的数据.
- 采用竞争风险分析和传统的生存分析来评估死亡率.
- 开发并验证了使用培训 (16,580名患者) 和验证 (7100名患者) 集的预测性名录.
主要成果:
- 与传统的生存分析相比,竞争风险模型产生了较低的特定死亡率.
- 确定了许多特定死亡率的独立预测因素,包括年龄,婚姻状况,种族,性别,瘤特征 (等级,阶段,大小),治疗 (手术,化疗) 和转移.
- 诺米图表表现出高预测准确度,C统计值为0.821 (训练) 和0.829 (验证),ROC曲线下的有利区域为1年,3年和5年的癌症特异性存活率.
结论:
- 基于竞争性风险模型开发的预测性名谱对于估计直肠癌的特定时间死亡率非常准确.
- 这种工具可以在临床决策和为直肠癌患者定制后续策略方面显著帮助医生.
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