PDF(Pubmed)
Abstract：
BACKGROUND: Sarculator and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms are freely available risk prediction scores for surgically treated patients with primary sarcomas. Due to the rarity of angiosarcomas, these scores have only been tested on small cohorts of angiosarcoma patients. In neither the original patient cohort upon which the Sarculator is based nor in subsequent studies was a distinction made between primary and secondary angiosarcomas, as the app is intended to be applied to primary sarcomas. Therefore, the objective of our investigation was to assess whether the Sarculator reveals a difference in prognosis and whether such differentiation aligns with actual clinical data.
METHODS: Thirty-one patients with primary or secondary soft tissue angiosarcoma, treated at our Sarcoma Center from 2001 to 2023, were included in the study. Actual survival rates were compared with nomogram-derived data for predicted 5-year survival (Sarculator), as well as 4-, 8- and 12-year sarcoma-specific death probabilities (MSKCC). Harrell\'s c-index was utilized to assess predictive validity.
RESULTS: In total, 31 patients were analyzed. The actual overall 5-year survival was 22.57% with a predicted 5-year survival rate of 25.97%, and the concordance index was 0.726 for the entire cohort. The concordance index results from MSKCC for angiosarcoma patients were below 0.7 indicating limited predictive accuracy in this cohort, particularly when compared to Sarculator.
CONCLUSIONS: Nomogram-based predictive models are valuable tools in clinical practice for rapidly assessing prognosis. They can streamline the decision-making process for adjuvant treatments and improve patient counselling especially in the treatment of rare and complicated tumor entities such as angiosarcomas.
METHODS: Thirty-one patients with primary or secondary soft tissue angiosarcoma, treated at our Sarcoma Center from 2001 to 2023, were included in the study. Actual survival rates were compared with nomogram-derived data for predicted 5-year survival (Sarculator), as well as 4-, 8- and 12-year sarcoma-specific death probabilities (MSKCC). Harrell\'s c-index was utilized to assess predictive validity.
RESULTS: In total, 31 patients were analyzed. The actual overall 5-year survival was 22.57% with a predicted 5-year survival rate of 25.97%, and the concordance index was 0.726 for the entire cohort. The concordance index results from MSKCC for angiosarcoma patients were below 0.7 indicating limited predictive accuracy in this cohort, particularly when compared to Sarculator.
CONCLUSIONS: Nomogram-based predictive models are valuable tools in clinical practice for rapidly assessing prognosis. They can streamline the decision-making process for adjuvant treatments and improve patient counselling especially in the treatment of rare and complicated tumor entities such as angiosarcomas.
摘要：
背景：Sarculator和MemorialSloanKettering癌症中心（MSKCC）列线图是经手术治疗的原发性肉瘤患者的免费风险预测评分。由于血管肉瘤的稀有性,这些评分仅在小群血管肉瘤患者中进行过测试.在Sarculator所基于的原始患者队列中，以及在随后的研究中，都没有区分原发性和继发性血管肉瘤。因为该应用程序旨在应用于初级肉瘤。因此,我们研究的目的是评估Sarculator是否显示预后差异,以及这种分化是否与实际临床数据相符.
方法：31例原发性或继发性软组织血管肉瘤，2001年至2023年在我们的肉瘤中心接受治疗，纳入研究。将实际生存率与预测5年生存率的列线图数据进行比较（Sarculator），以及4-,8年和12年肉瘤特异性死亡概率（MSKCC）。Harrell的c指数用于评估预测效度。
结果：总计，对31例患者进行分析。实际5年总生存率为22.57%，预测5年生存率为25.97%，整个队列的一致性指数为0.726.MSKCC对血管肉瘤患者的一致性指数低于0.7，表明该队列的预测准确性有限。特别是当与Sarculator相比时。
结论：基于列线图的预测模型是临床实践中快速评估预后的有价值的工具。它们可以简化辅助治疗的决策过程，并改善患者咨询，特别是在治疗罕见和复杂的肿瘤实体（如血管肉瘤）方面。
方法：31例原发性或继发性软组织血管肉瘤，2001年至2023年在我们的肉瘤中心接受治疗，纳入研究。将实际生存率与预测5年生存率的列线图数据进行比较（Sarculator），以及4-,8年和12年肉瘤特异性死亡概率（MSKCC）。Harrell的c指数用于评估预测效度。
结果：总计，对31例患者进行分析。实际5年总生存率为22.57%，预测5年生存率为25.97%，整个队列的一致性指数为0.726.MSKCC对血管肉瘤患者的一致性指数低于0.7，表明该队列的预测准确性有限。特别是当与Sarculator相比时。
结论：基于列线图的预测模型是临床实践中快速评估预后的有价值的工具。它们可以简化辅助治疗的决策过程，并改善患者咨询，特别是在治疗罕见和复杂的肿瘤实体（如血管肉瘤）方面。
