背景:转移性软组织肉瘤(STS)患者的预后较差,3年生存率为25%。其中约30%存在肺转移(LM)。这项研究旨在构建2列线图来预测LM的风险和患有LM的STS患者的总体生存率。材料和方法:患者的数据来自监测,流行病学,2010年至2015年期间的最终结果数据库。Logistic和Cox分析确定STS患者LM的独立危险因素和预后因素。分别。之后,2列线图是,分别,建立在这些因素的基础上。使用接收器工作特性曲线评估了开发的列线图的性能,曲线下面积(AUC)校准曲线,和决策曲线分析(DCA)。结果:本研究共纳入7643例STS患者。首次诊断STS患者LM的独立预测因子为N期,grade,组织学类型,和肿瘤大小。STS合并LM患者的独立预后因素是年龄,N级,手术,和化疗。诊断列线图的AUC在训练集中为0.806,在测试集中为0.799。对于预后列线图,训练集和测试集的时间依赖性AUC值表明列线图具有良好的表现和区分度.1-,2-,3年的AUC值在训练集中分别为0.698、0.718和0.715,测试集中的0.669、0.612和0717,分别。此外,对于两个列线图,校准曲线表明预测和实际生存之间令人满意的一致性,DCA显示了其临床应用价值。结论:在这项研究中,grade,组织学,N级,肿瘤大小是STS患者LM的独立危险因素,年龄,化疗手术,N分期是STS患者LM的独立预后因素,这些形成的列线图可能是准确预测新诊断的LM患者的风险和预后的有效工具.
Background: Metastatic soft tissue sarcoma (STS) patients have a poor prognosis with a 3-year survival rate of 25%. About 30% of them present lung metastases (LM). This study aimed to construct 2 nomograms to predict the risk of LM and overall survival of STS patients with LM. Materials and Methods: The data of patients were derived from the Surveillance, Epidemiology, and End Results database during the period of 2010 to 2015. Logistic and Cox analysis was performed to determine the independent risk factors and prognostic factors of STS patients with LM, respectively. Afterward, 2 nomograms were, respectively, established based on these factors. The performance of the developed nomogram was evaluated with receiver operating characteristic curves, area under the curve (AUC) calibration curves, and decision curve analysis (DCA). Results: A total of 7643 patients with STS were included in this study. The independent predictors of LM in first-diagnosed STS patients were N stage, grade, histologic type, and tumor size. The independent prognostic factors for STS patients with LM were age, N stage, surgery, and chemotherapy. The AUCs of the diagnostic nomogram were 0.806 in the training set and 0.799 in the testing set. For the prognostic nomogram, the time-dependent AUC values of the training and testing set suggested a favorable performance and discrimination of the nomogram. The 1-, 2-, and 3-year AUC values were 0.698, 0.718, and 0.715 in the training set, and 0.669, 0.612, and 0717 in the testing set, respectively. Furthermore, for the 2 nomograms, calibration curves indicated satisfactory agreement between prediction and actual survival, and DCA indicated its clinical usefulness. Conclusion: In this study, grade, histology, N stage, and tumor size were identified as independent risk factors of LM in STS patients, age, chemotherapy surgery, and N stage were identified as independent prognostic factors of STS patients with LM, these developed nomograms may be an effective tool for accurately predicting the risk and prognosis of newly diagnosed patients with LM.