Survival study of patients with stage N1-3 testicular seminoma
10.3760/cma.j.issn.1673-422X.2019.09.004
- VernacularTitle: N1-3期睾丸精原细胞瘤患者的生存研究
- Author:
Guangdong HOU
1
;
Yu ZHENG
1
;
Jianhua JIAO
1
;
Fuli WANG
1
;
Fenghua SHI
2
;
Geng ZHANG
1
;
Ping MENG
1
;
Xinlong DUN
1
;
Jianlin YUAN
1
Author Information
1. Department of Urology Surgery, Xijing Hospital of Air Force Medical University, Xi′an 710032, China
2. Department of Urology Surgery, Tangdu Hospital of Air Force Medical University, Xi′an 710038, China
- Publication Type:Journal Article
- Keywords:
Seminoma;
Lymphatic metastasis;
Prognosis;
Nomogram
- From:
Journal of International Oncology
2019;46(9):531-535
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the independent predictors for disease-specific survival (DSS) rate in patients with stage N1-3 testicular seminoma (TS), and establish a nomogram to predict individual 5-year DSS.
Methods:The data of N1-3 TS patients registered in the SEER database of National Cancer Institute (USA) from January 2004 to December 2015 were retrospectively analyzed. The 5-year overall survival (OS) rate and DSS rate were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using log-rank test. Besides, the independent predictors of DSS were defined using multivariate Cox regression analysis, and nomogram was drawn using R software. Furthermore, the predictive performance of the nomogram was internally validated using the C-index and calibration plot.
Results:TNM stage ⅢA (HR=5.604, 95%CI: 1.252-25.083, P=0.024), ⅢB (HR=6.710, 95%CI: 1.923-23.410, P=0.003) and ⅢC (HR=13.189, 95%CI: 3.916-44.420, P<0.001), age at diagnosis ≥45 years old (HR=3.575, 95%CI: 2.014-6.344, P<0.001), and patients without spouse (HR=2.346, 95%CI: 1.406-3.914, P=0.001) were identified as independent risk factors for DSS. On internal validation, the predictive accuracy of our nomogram was 0.751 (C-index: 0.751, 95%CI: 0.694-0.808). Besides, the calibration plot showed that the predicted survival outcomes were highly consistent with the actual survival outcomes.
Conclusion:The study confirms that age at diagnosis ≥45 years old, TNM stage ≥ⅢA and patients without spouse are the independent risk factors for DSS in TS patients with stage N1-3, and the nomogram for predicting individual 5-year DSS is established.
