Construction and validation of nomogram to predict distant metastasis in osteosarcoma: a retrospective study

Lu, Shouliang; Wang, Yanhua; Liu, Guangfei; Wang, Lu; Wu, Pengfei; Li, Yong; Cheng, Can

doi:10.1186/s13018-021-02376-8

Cited by 21 publications

(26 citation statements)

References 32 publications

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“…To date, most studies stopped at independent risk factors and only one realistic model has been established to predict the risk of DM in osteosarcoma patients. In the similar predictive tool established by Li et al (40), surgery, a post-diagnosis treatment was included in the nomogram for the diagnosis of DM. This sequential relationship was reverse and irrational, resulting in the model's uselessness.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors, Prognostic Factors, and Nomograms for Distant Metastasis in Patients With Newly Diagnosed Osteosarcoma: A Population-Based Study

et al. 2021

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BackgroundOsteosarcoma is the most common bone cancer, mainly occurring in children and adolescents, among which distant metastasis (DM) still leads to a poor prognosis. Although nomogram has recently been used in tumor areas, there are no studies focused on diagnostic and prognostic evaluation of DM in primary osteosarcoma patients.MethodsThe data of osteosarcoma patients diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in osteosarcoma patients, and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors of osteosarcoma patients with DM. We then established two novel nomograms and the results were evaluated by receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).ResultA total of 1,657 patients with osteosarcoma were included, and 267 patients (16.11%) had DM at the time of diagnosis. The independent risk factors for DM in patients with osteosarcoma include age, grade, T stage, and N stage. The independent prognostic factors for osteosarcoma patients with DM are age, chemotherapy and surgery. The results of ROC curves, calibration, DCA, and Kaplan–Meier (K-M) survival curves in the training, validation, and expanded testing sets, confirmed that two nomograms can precisely predict occurrence and prognosis of DM in osteosarcoma patients.ConclusionTwo nomograms are expected to be effective tools for predicting the risk of DM for osteosarcoma patients and personalized prognosis prediction for patients with DM, which may benefit clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Risk Factors, Prognostic Factors, and Nomograms for Distant Metastasis in Patients With Newly Diagnosed Osteosarcoma: A Population-Based Study

et al. 2021

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“…We used LASSO regression analysis to identify ve risk factors for metastasis of spinal and pelvic osteosarcoma:sex,race,grade,number of primary tumor and surgery.Our study showed that female patients and black patients with spinal and pelvic osteosarcoma were less likely to metastasis,which may provide some reference for clinical treatment decisions.Tumor grade is the description of a tumor based on how abnormal the tumor cells and the tumor tissue look under a microscope [4].In our study,the high grade was a risk factor for metastasis of spinal and pelvic osteosarcoma,which should be related to the rapid growth and diffusion of poorly differentiated or undifferentiated tumor cells.In addition,we found that patients with single primary tumors are more likely to metastasize than patients with multiple primary.There are no studies on relationship between number of primary tumor and distant metastasis of spinal and pelvic osteosarcoma,currently.We thought that molecular and biochemical studies of tumors may be needed to explain this.…”

Section: Discussionmentioning

confidence: 74%

“…Osteosarcoma is the most common primary malignant bone tumor,it was reported that the annual prevalence of osteosarcoma ranges 0.2-3 cases per 100,000 people [1].However,spinal and pelvic osteosarcoma is more rare compared with osteosarcoma in other sites.It was reported that spinal osteosarcoma accounts for 3% of all osteosarcomas, while pelvic osteosarcoma accounts for less than 10% of all osteosarcomas [2,3].There are some studies on prediction of distant metastasis of osteosarcoma in all sites [4,5].Nonetheless,there was no similar studies on prediction of distant metastasis of spinal and pelvic osteosarcoma because of low incidence.…”

Section: Introductionmentioning

confidence: 99%

Prediction of distant metastasis of spinal and pelvic osteosarcoma by constructing and validating nomogram:a retrospective study based on SEER database

Wang

Chen

et al. 2022

Preprint

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Background:Spinal and pelvic osteosarcoma is a rare type of all osteosarcomas,and distant metastasis is an important factor for poor prognosis of this disease. There are no similar studies on prediction of distant metastasis of spinal and pelvic osteosarcoma. We aim to construct and validate a nomogram to predict the risk of distant metastasis of spinal and pelvic osteosarcoma.Methods:We collected the data on patients with spinal and pelvic osteosarcoma from the Surveillance, Epidemiology, and End Results(SEER) database retrospectively. The Kaplan-Meier curve was used to compare differences in survival time between patients with metastasis and non-metastasis. Total patients were randomly divided into training cohort and validation cohort. The risk factor of distant metastasis were identified via the least absolute shrinkage and selection operator(LASSO) regression and multivariate logistic analysis. The nomogram we constructed were validated internally and externally by C-index, calibration curves,receiver operating characteristic(ROC) curve and Decision curve analysis (DCA).Results:The Kaplan-Meier curve showed that the survival time of non-metastatic patients was longer than that of metastatic patients(P＜0.001).All patients(n=358) were divided into training cohort(n=269) and validation cohort(n=89).The LASSO regression selected five meaningful variables in the training cohort. The multivariate logistic regression analysis demonstrated that surgery(yes,OR=0.175, 95%CI=0.095-0.321,p=0.000) was the independent risk factors for distant metastasis of patients with spinal and pelvic osteosarcoma. The C-index and calibration curves showed the good agreement between the predicted results and the actual results. The area under the receiver operating characteristic curve(AUC) values were 0.748(95%CI=0.687-0.817) and 0.758(95%CI=0.631-0.868) in the training and validation cohorts respectively. The DCA showed that the nomogram has a good clinical usefulness and net benefit.Conclusion:No surgery is the independent risk factor of distant metastasis of spinal and pelvic osteosarcoma. The nomogram we constructed to predict the probability of distant metastasis of patients with spinal and pelvic osteosarcoma is reliable and effective by internal and external verification.

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“…It can help clinicians better diagnose and determine treatment options. Applying nomograms to assess metastatic status is necessary (48). Nomograms are rarely reported in predicting metastasis in osteosarcoma.…”

Section: Discussionmentioning

confidence: 99%

Osteosarcoma immune prognostic index can indicate the nature of indeterminate pulmonary nodules and predict the metachronous metastasis in osteosarcoma patients

et al. 2022

Front. Oncol.

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PurposeThe relationship between indeterminate pulmonary nodules (IPNs) and metastasis is difficult to determine. We expect to explore a predictive model that can assist in indicating the nature of IPNs, as well as predicting the probability of metachronous metastasis in osteosarcoma patients.Patients and methodsWe conducted a retrospective study including 184 osteosarcoma patients at West China Hospital from January 2016 to January 2021. Hematological markers and clinical features of osteosarcoma patients were collected and analyzed.ResultsIn this study, we constructed an osteosarcoma immune prognostic index (OIPI) based on the lung immune prognostic index (LIPI). Compared to other hematological markers and clinical features, OIPI had a better ability to predict metastasis. OIPI divided 184 patients into four groups, with the no-OIPI group (34 patients), the light-OIPI group (35 patients), the moderate-OIPI group (75 patients), and the severe-OIPI group (40 patients) (P < 0.0001). Subgroup analysis showed that the OIPI could have a stable predictive effect in both the no-nodule group and the IPN group. Spearman’s rank correlation test and Kruskal–Wallis test demonstrated that the OIPI was related to metastatic site and metastatic time, respectively. In addition, patients with IPNs in high-OIPI (moderate and severe) groups were more likely to develop metastasis than those in low-OIPI (none and light) groups. Furthermore, the combination of OIPI with IPNs can more accurately identify patients with metastasis, in which the high-OIPI group had a higher metastasis rate, and the severe-OIPI group tended to develop metastasis earlier than the no-OIPI group. Finally, we constructed an OIPI-based nomogram to predict 3- and 5-year metastasis rates. This nomogram could bring net benefits for more patients according to the decision curve analysis and clinical impact curve.ConclusionThis study is the first to assist chest CT in diagnosing the nature of IPNs in osteosarcoma based on hematological markers. Our findings suggested that the OIPI was superior to other hematological markers and that OIPI can act as an auxiliary tool to determine the malignant transformation tendency of IPNs. The combination of OIPI with IPNs can further improve the metastatic predictive ability in osteosarcoma patients.

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Construction and validation of nomogram to predict distant metastasis in osteosarcoma: a retrospective study

Cited by 21 publications

References 32 publications

Risk Factors, Prognostic Factors, and Nomograms for Distant Metastasis in Patients With Newly Diagnosed Osteosarcoma: A Population-Based Study

Risk Factors, Prognostic Factors, and Nomograms for Distant Metastasis in Patients With Newly Diagnosed Osteosarcoma: A Population-Based Study

Prediction of distant metastasis of spinal and pelvic osteosarcoma by constructing and validating nomogram:a retrospective study based on SEER database

Osteosarcoma immune prognostic index can indicate the nature of indeterminate pulmonary nodules and predict the metachronous metastasis in osteosarcoma patients

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