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Erschienen in:
28.12.2017 | Original Scientific Report
A Nomogram to Predict Prognosis in Malignant Pleural Mesothelioma
Erschienen in: World Journal of Surgery | Ausgabe 7/2018
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Background
Malignant pleural mesothelioma (MPM) is a rare malignancy with heterogeneous outcomes. This study was aimed to develop a nomogram to precisely and visually predict survival of MPM patients.
Methods
Data from Surveillance, Epidemiology, and End Results database (1973–2014) on MPM were screened and retrieved. The prognostic effects of variables, including age, sex, race, year of diagnosis, laterality, histology, tumor stage, surgery, chemotherapy, and radiotherapy were analyzed using Kaplan–Meier method and Cox proportional hazard model. A nomogram was formulated to predict overall survival of MPM patients.
Results
A total of 1092 cases who met inclusion criteria were included in this study. The overall 1-, 2-, and 3-year survival rate in the entire cohort was 45.1, 23.0, and 12.1%, with median survival of 11 months. Cox regression analysis showed that age (P < 0.001), race (P = 0.003), histology type (P < 0.001), T stage (P < 0.001), M stage (P < 0.001), TNM stage (P < 0.001), cancer-directed surgery (P < 0.001), and chemotherapy (P < 0.001) were all independent prognostic factors of MPM patients. A nomogram was established based on the results of multivariate analysis. The internal bootstrap resampling approach suggested the nomogram had sufficient discriminatory power with the C-index of 0.705 (95% CI 0.681–0.729). The calibration plots also demonstrated good consistence between the prediction and the observation.
Conclusions
We developed a nomogram to accurately predict clinical outcomes of MPM patients based on individual characteristics. Risk stratification by the survival nomogram could optimize individual therapies and follow-up.