Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma

Abstract Background Models for estimation of survival rates of patients with intracranial grade II/III ependymoma (EPN) are scarce. Considering the heterogeneity in prognostic factors between pediatric and adult patients, we aimed to develop age‐specific nomograms for predicting 3‐, 5‐, and 8‐year s...

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Main Authors: Xiangyang Deng, Xiaojia Zhang, Liang Yang, Xiangqi Lu, Junhao Fang, Lisheng Yu, Dandong Li, Hansong Sheng, Bo Yin, Nu Zhang, Jian Lin
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.2753
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author Xiangyang Deng
Xiaojia Zhang
Liang Yang
Xiangqi Lu
Junhao Fang
Lisheng Yu
Dandong Li
Hansong Sheng
Bo Yin
Nu Zhang
Jian Lin
author_facet Xiangyang Deng
Xiaojia Zhang
Liang Yang
Xiangqi Lu
Junhao Fang
Lisheng Yu
Dandong Li
Hansong Sheng
Bo Yin
Nu Zhang
Jian Lin
author_sort Xiangyang Deng
collection DOAJ
description Abstract Background Models for estimation of survival rates of patients with intracranial grade II/III ependymoma (EPN) are scarce. Considering the heterogeneity in prognostic factors between pediatric and adult patients, we aimed to develop age‐specific nomograms for predicting 3‐, 5‐, and 8‐year survival for these patients. Methods A total of 1390 cases (667 children; 723 adults) of intracranial grade II/III EPNs diagnosed between 1988 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for our study. Univariable and multivariable Cox analyses were employed to identify independent prognostic predictors. Age‐specific nomograms were developed based on the results of multivariate Cox analyses. We also evaluated the performance of these predictive models by concordance index, calibration curves, time‐dependent receiver operating characteristic curves, and decision curve analyses. Results Considerable heterogeneity in prognostic factors was highlighted between pediatric and adult patients. Age, sex, tumor grade, surgery treatment and radiotherapy were identified as significant predictors of overall survival for children, and age, tumor grade, tumor size, surgery treatment, and marital status for adult. Based on these factors, age‐specific nomogram models were established and internally validated. These models exhibited favorable discrimination and calibration characteristics. Nomogram‐based risk classification systems were also constructed to facilitate risk stratification in EPNs for optimization of clinical management. Conclusions We developed the first nomograms and corresponding risk classification systems for predicting survival in patients with intracranial grade II/III EPN. These easily used tools can assist oncologists in making accurate survival evaluation.
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spelling doaj-art-ea8bac88fba1496ba2cbb6be667570832025-08-25T10:14:05ZengWileyCancer Medicine2045-76342020-01-019261562510.1002/cam4.2753Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymomaXiangyang Deng0Xiaojia Zhang1Liang Yang2Xiangqi Lu3Junhao Fang4Lisheng Yu5Dandong Li6Hansong Sheng7Bo Yin8Nu Zhang9Jian Lin10Department of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurosurgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaAbstract Background Models for estimation of survival rates of patients with intracranial grade II/III ependymoma (EPN) are scarce. Considering the heterogeneity in prognostic factors between pediatric and adult patients, we aimed to develop age‐specific nomograms for predicting 3‐, 5‐, and 8‐year survival for these patients. Methods A total of 1390 cases (667 children; 723 adults) of intracranial grade II/III EPNs diagnosed between 1988 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for our study. Univariable and multivariable Cox analyses were employed to identify independent prognostic predictors. Age‐specific nomograms were developed based on the results of multivariate Cox analyses. We also evaluated the performance of these predictive models by concordance index, calibration curves, time‐dependent receiver operating characteristic curves, and decision curve analyses. Results Considerable heterogeneity in prognostic factors was highlighted between pediatric and adult patients. Age, sex, tumor grade, surgery treatment and radiotherapy were identified as significant predictors of overall survival for children, and age, tumor grade, tumor size, surgery treatment, and marital status for adult. Based on these factors, age‐specific nomogram models were established and internally validated. These models exhibited favorable discrimination and calibration characteristics. Nomogram‐based risk classification systems were also constructed to facilitate risk stratification in EPNs for optimization of clinical management. Conclusions We developed the first nomograms and corresponding risk classification systems for predicting survival in patients with intracranial grade II/III EPN. These easily used tools can assist oncologists in making accurate survival evaluation.https://doi.org/10.1002/cam4.2753grade II/III ependymomaintracranialnomogramoverall survivalSEER
spellingShingle Xiangyang Deng
Xiaojia Zhang
Liang Yang
Xiangqi Lu
Junhao Fang
Lisheng Yu
Dandong Li
Hansong Sheng
Bo Yin
Nu Zhang
Jian Lin
Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
Cancer Medicine
grade II/III ependymoma
intracranial
nomogram
overall survival
SEER
title Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
title_full Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
title_fullStr Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
title_full_unstemmed Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
title_short Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma
title_sort personalizing age specific survival prediction and risk stratification in intracranial grade ii iii ependymoma
topic grade II/III ependymoma
intracranial
nomogram
overall survival
SEER
url https://doi.org/10.1002/cam4.2753
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