Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy

In this study, we established and validated a competing risk nomogram for predicting the cumulative incidence of cervical adenosquamous carcinoma (ASC)-specific death in patients undergoing radical hysterectomy. Patients diagnosed with ASC between 2010 and 2019 were retrieved from the Surveillance,...

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Main Authors: Jianying Yi, Jie Chen, Xi Cao, Lili Pi, Chunlei Zhou, Zhili Liu, Hong Mu
Format: Article
Language:English
Published: Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina 2024-11-01
Series:Biomolecules & Biomedicine
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Online Access:https://bjbms.org/ojs/index.php/bjbms/article/view/11217
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author Jianying Yi
Jie Chen
Xi Cao
Lili Pi
Chunlei Zhou
Zhili Liu
Hong Mu
author_facet Jianying Yi
Jie Chen
Xi Cao
Lili Pi
Chunlei Zhou
Zhili Liu
Hong Mu
author_sort Jianying Yi
collection DOAJ
description In this study, we established and validated a competing risk nomogram for predicting the cumulative incidence of cervical adenosquamous carcinoma (ASC)-specific death in patients undergoing radical hysterectomy. Patients diagnosed with ASC between 2010 and 2019 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The cumulative incidence function (CIF) for various variables influencing ASC-specific mortality was computed. A Fine-Gray competing risk model was used to identify independent predictors, formulating a competing risk nomogram. A multivariate Cox proportional hazards model was also applied for comparative analysis. The performance of the nomogram was assessed using metrics such as the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A corresponding risk classification system was constructed based on nomogram-derived scores. Factors such as advanced age, racial background (Black race), higher tumor grade, increased tumor size, advanced TNM stage, and receipt of radiotherapy without chemotherapy were found to be positively associated with elevated ASC-specific mortality. Additionally, age, T stage, M stage, and chemotherapy were identified as independent predictors correlated with ASC-specific mortality. The established nomogram exhibited accurate discriminatory capabilities and superior net benefits compared to the traditional TNM staging system. Additionally, the high-risk group consistently demonstrated higher probabilities of ASC-specific death in both the training and validation sets. The developed nomogram proficiently quantified the incidence of ASC-specific death in patients subjected to radical hysterectomy for ASC. This tool could help clinicians in formulating personalized treatment strategies and devising follow-up protocols.
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spelling doaj-art-1969315329914e7eb9abc0e57f66cf612025-08-20T02:13:27ZengAssociation of Basic Medical Sciences of Federation of Bosnia and HerzegovinaBiomolecules & Biomedicine2831-08962831-090X2024-11-0110.17305/bb.2024.11217Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomyJianying Yi0Jie Chen1Xi Cao2Lili Pi3Chunlei Zhou4Zhili Liu5Hong Mu6https://orcid.org/0009-0006-2480-6035Department of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, The Third Central Hospital, Tianjin, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Artificial Cell Engineering Technology Research Center, Tianjin, China; Tianjin Institute of Hepatobiliary Disease, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, ChinaIn this study, we established and validated a competing risk nomogram for predicting the cumulative incidence of cervical adenosquamous carcinoma (ASC)-specific death in patients undergoing radical hysterectomy. Patients diagnosed with ASC between 2010 and 2019 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The cumulative incidence function (CIF) for various variables influencing ASC-specific mortality was computed. A Fine-Gray competing risk model was used to identify independent predictors, formulating a competing risk nomogram. A multivariate Cox proportional hazards model was also applied for comparative analysis. The performance of the nomogram was assessed using metrics such as the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A corresponding risk classification system was constructed based on nomogram-derived scores. Factors such as advanced age, racial background (Black race), higher tumor grade, increased tumor size, advanced TNM stage, and receipt of radiotherapy without chemotherapy were found to be positively associated with elevated ASC-specific mortality. Additionally, age, T stage, M stage, and chemotherapy were identified as independent predictors correlated with ASC-specific mortality. The established nomogram exhibited accurate discriminatory capabilities and superior net benefits compared to the traditional TNM staging system. Additionally, the high-risk group consistently demonstrated higher probabilities of ASC-specific death in both the training and validation sets. The developed nomogram proficiently quantified the incidence of ASC-specific death in patients subjected to radical hysterectomy for ASC. This tool could help clinicians in formulating personalized treatment strategies and devising follow-up protocols. https://bjbms.org/ojs/index.php/bjbms/article/view/11217Competing risk nomogramcervical adenosquamous carcinomacancer-specific mortalityradical hysterectomySEER
spellingShingle Jianying Yi
Jie Chen
Xi Cao
Lili Pi
Chunlei Zhou
Zhili Liu
Hong Mu
Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
Biomolecules & Biomedicine
Competing risk nomogram
cervical adenosquamous carcinoma
cancer-specific mortality
radical hysterectomy
SEER
title Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
title_full Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
title_fullStr Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
title_full_unstemmed Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
title_short Development and validation of the competing risk nomogram and risk classification system for predicting cancer-specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
title_sort development and validation of the competing risk nomogram and risk classification system for predicting cancer specific mortality in patients with cervical adenosquamous carcinoma treated via radical hysterectomy
topic Competing risk nomogram
cervical adenosquamous carcinoma
cancer-specific mortality
radical hysterectomy
SEER
url https://bjbms.org/ojs/index.php/bjbms/article/view/11217
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