Construction and validation of a prognostic model for predicting overall survival of primary adrenal malignant tumor patients: A population-based study with 1,080 patients

Abstract

ObjectivePrimary adrenal malignant tumor is rare. The factors affecting the prognosis remain poorly defined. This study targeted to construct and corroborate a model for predicting the overall survival of adrenal malignant tumor patients.MethodsWe investigated the SEER database for patients with primary adrenal malignant tumor. 1,080 patients were divided into a construction cohort (n = 756) and a validation cohort (n = 324), randomly. The prognostic factors for overall survival were evaluated using univariate and multivariate Cox analyses. The nomogram was constructed and then validated with C-index, calibration curve, time-dependent ROC curve, and decision curve analysis in both cohorts. Then we divided the patients into 3 different risk groups according to the total points of the nomogram and analyzed their survival status by Kaplan-Meier curve with log-rank test.ResultsThe baseline characteristics of these two cohorts were not statistically different (P > 0.05). Using univariate and multivariate Cox analyses, 5 variables, including age, tumor size, histological type, tumor stage, and surgery of primary site, were distinguished as prognostic factors (P < 0.05). Based on these variables, we constructed a nomogram to predict the 3- year, 5- year, and 10-year overall survival. The C-indexes were 0.780 (0.760–0.800) in the construction cohort and 0.780 (0.751–0.809) in the validation cohort. In both cohorts, the AUC reached a fairly high level at all time points. The internal and external calibration curves and ROC analysis showed outstanding accuracy and discrimination. The decision curves indicated excellent clinical usefulness. The best cut-off values for the total points of the nomogram were 165.4 and 243.1, and the prognosis was significantly different for the three different risk groups (P < 0.001).ConclusionWe successfully constructed a model to predict the overall survival of primary adrenal malignant tumor patients. This model was validated to perform brilliantly internally and externally, which can assist us in individualized clinical management.

Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study

“…Many studies have been conducted on the prognosis, diagnosis, and treatment of malignant adrenal tumors. Researchers have found that patient age, the initial stage of diagnosis, and surgical resection might affect the prognosis of patients with adrenal malignancies ( 6 , 21 , 22 ). However, most studies limited the tumor to a single histological type or only studied one prognostic factor and only the OS of patients.…”

Estimation of the tumor size at cure threshold among adult patients with adrenocortical carcinoma: A populational-based study

“…Patients were diagnosed as adrenal gland (primary site C74.0) with adrenal cortical carcinoma (ICD-0-3 Hist/behav code 8370) between 2004 and 2015 year. Based on the SEER Combined Summary Stage 2000 (2004–2017), the stage of tumor was restaged as localized only (I), regional lymph nodes involved only (II), regional by direct extension only (III), regional by both direct extension and lymph node involvement (IV) and distant site(s)/node(s) involved (V) [ 24 ]. The inclusion criteria were as followings: (1) Primary tumor site is adrenal gland.…”