The Construction and Development of a Clinical Prediction Model to Assess Lymph Node Metastases in Osteosarcoma

Abstract

Background: This study aimed to construct a clinical prediction model for osteosarcoma patients to evaluate the influence factors for the occurrence of lymph node metastasis (LNM).Methods: In our retrospective study, a total of 1,256 patients diagnosed with chondrosarcoma were enrolled from the SEER (Surveillance, Epidemiology, and End Results) database (training cohort, n = 1,144) and multicenter dataset (validation cohort, n = 112). Both the univariate and multivariable logistic regression analysis were performed to identify the potential risk factors of LNM in osteosarcoma patients. According to the results of multivariable logistic regression analysis, A nomogram were established and the predictive ability was assessed by calibration plots, receiver operating characteristics (ROCs) curve, and decision curve analysis (DCA). Moreover, Kaplan-Meier plot of overall survival (OS) was plot and a web calculator visualized the nomogram.Results: Five independent risk factors [chemotherapy, surgery, lung metastases, lymphatic metastases (M-stage) and tumor size (T-stage)] were identified by multivariable logistic regression analysis. What's more, calibration plots displayed great power both in training and validation group. DCA presented great clinical utility. ROCs curve provided the predictive ability in the training cohort (AUC = 0.805) and the validation cohort (AUC = 0.808). Moreover, patients in LNN group had significantly better survival than that in LNP group both in training and validation group.Conclusion: In this study, we constructed and developed a nomogram with risk factors, which performed well in predicting risk factors of LNM in osteosarcoma patients. It may give a guide for surgeons and oncologists to optimize individual treatment and make a better clinical decision.

Development and Validation of Nomogram-Based Prognosis Tools for Patients with Extremity Osteosarcoma: A SEER Population Study

“…Most patients with osteosarcoma having undergone extremity salvage surgery instead of amputation during the period of chemotherapy can keep the majority of their limb functions, as well as improve their quality of life [ 43 ]. This also suggests that surgeons should continue to strive to salvage as much of the limb as possible when performing tumour resections [ 44 ].…”

A Visualized Dynamic Prediction Model for Lymphatic Metastasis in Ewing's Sarcoma for Smart Medical Services

“…Nomogram was much more convenient to obtain the predictors. Hence, it was considered a big advantage over traditional staging, which had been proposed as an alternative and even a new standard to guide the treatment of cancer patients ( 17 , 28 , 29 ). We screened the clinical information of 929 patients with ES using a SEER database and found that survival time, race, T stage, M stage, surgery, and lung metastasis were significant factors that affected lymphatic metastasis in ES patients.…”

Web-Based Prediction Models for Overall Survival and Cancer-Specific Survival of Patients With Primary Urachal Carcinoma: A Study Based on SEER Database

“…Other uncommon clinical signs include urinary tract infections, umbilical infections, painful urination, and periumbilical masses ( 10 ). Some patients develop distant metastases even after surgery, such as liver, lung, bone, pelvic, and retroperitoneal lymph nodes, and there are no accepted data describing the probability of metastases to different organs and tissues ( 9 , 25 ). Existing immunology and molecular biology studies have discovered a link between umbilical ductal carcinoma and gastrointestinal cancers, such as CD7 and KRAS ( 26 , 27 ).…”