Marital Status and Prognostic Nomogram for Bladder Cancer With Distant Metastasis: A SEER-Based Study

Abstract

Background: To investigate the impact of marital status on overall survival (OS) and create a prognostic nomogram predicting OS in distant-metastatic bladder cancer (DMBC) patients. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was explored to recruit DMBC patients from 2010 to 2015. Kaplan-Meier survival analysis was used to compare survival differences among different marital status. Univariate and multivariate analyses were used to screen for prognostic factors and then constructed the nomogram based on Cox proportional hazard regression models. Calibration plot diagrams and concordance index (C-index) were used to verify the prognostic nomogram. Results: Kaplan-Meier curves suggested the significant differences of OS among different marital status existed in total (P < 0.001), female (P = 0.011) and male (P = 0.001) DMBC patients, respectively. Multivariate analysis indicated marital status was an independent prognostic factor for OS of DMBC patients. Nomogram showed the contribution of marital status to predicting OS was small. Other independent prognostic factors included age, grade, histology type, surgery of primary site, chemotherapy, and metastasis pattern. By combining seven factors, we constructed a prognostic nomogram for DMBC patients. The C-index of this nomogram for OS prediction was 0.722 (95% CI 0.712-0.732). The calibration curves showed perfect consistency between observed and predictive survival. Conclusions: Marital status was an independent prognostic factor for OS of DMBC patients, but its contribution to predicting OS was small. The prognostic nomogram will provide an individualized evaluation of OS and guidance for suitable treatments in DMBC patients.

A Novel Machine Learning Algorithm Combined With Multivariate Analysis for the Prognosis of Renal Collecting Duct Carcinoma

“…However, CDC is usually insensitive to these types of treatments ( 23 , 25 , 26 ). In previous studies, marital and economic statuses were reported to be associated with prognosis, but these were not defined as risk factors in the present study ( 27 , 28 ). This may be due to the extremely poor prognosis of this disease, with a large number of patients dying in a short time.…”

Development and Validation of a Prognostic Model for Predicting Overall Survival in Patients With Bladder Cancer: A SEER-Based Study

“…The nomogram has shown good classification as well as prediction accuracy in both the training set and test set. Further, the AUCs (>0.80) were superior to previous prognostic model (11,27,34) for BLCA patients. The optimized classification accuracy could be partly due to the increased sample size in the present study.…”

“…In comparison to SDW and unmarried patients, married patients have better prognosis. The protective effects of married marital status have been reported extensively (26)(27)(28). Most of BLCA cases were male; however, female patients tend to have worse survival.…”

Development and Validation of a Prognostic Nomogram in&nbsp;Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population

“…Compared to the COBRA model, the Cindex in our nomogram was high both in the training cohort (0.834 vs. 0.712) and validation cohort (0.834 vs. 0.705). Tao et al [26] indicated that marital status was an independent prognostic factor of OS in distant-metastatic BC patients, but its contribution to predicting OS was relative small. They constructed a prognostic models based on SEER population by utilizing eight variables, including marital status, age, tumor grade, histology type, primary surgery, chemotherapy and metastasis status.…”

“…Many reporters suggested other prognostic indicators such as lactate dehydrogenase (LDH), albumin count and relative platelet and blood indication levels, such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) [10][11][12][13]. Given the fact of different risk factors were found about the prognosis of BC, lots of prognostic models have been established [14][15][16].…”