Development, Validation, and Visualization of A Web-Based Nomogram for Predicting the Recurrence-Free Survival Rate of Patients With Desmoid Tumors

Abstract

BackgroundSurgery is an important treatment option for desmoid tumor (DT) patients, but how to decrease and predict the high recurrence rate remains a major challenge.MethodsDesmoid tumor patients diagnosed and treated at Tianjin Cancer Institute & Hospital were included, and a web-based nomogram was constructed by screening the recurrence-related risk factors using Cox regression analysis. External validation was conducted with data from the Fudan University Shanghai Cancer Center.ResultsA total of 385 patients were identified. Finally, after excluding patients without surgery, patients who were lost to follow-up, and patients without complete resection, a total of 267 patients were included in the nomogram construction. Among these patients, 53 experienced recurrence, with a recurrence rate of 20.15%. The 3-year and 5-year recurrence-free survival (RFS) rates were 82.5% and 78%, respectively. Age, tumor diameter, admission status, location, and tumor number were correlated with recurrence in univariate Cox analysis. In multivariate Cox analysis, only age, tumor diameter and tumor number were independent risk factors for recurrence and were then used to construct a web-based nomogram to predict recurrence. The concordance index (C-index) of the nomogram was 0.718, and the areas under the curves (AUCs) of the 3-year and 5-year receiver operating characteristic (ROC) curves were 0.751 and 0.761, respectively. In the external validation set, the C-index was 0.706, and the AUCs of the 3-year and 5-year ROC curves are 0.788 and 0.794, respectively.ConclusionsAge, tumor diameter, and tumor number were independent predictors of recurrence for DTs, and a web-based nomogram containing these three predictors could accurately predict RFS (https://stepforward.shinyapps.io/Desmoidtumor/).

T-Inverted Shaped Rectus Abdominis Myocutaneous (Ti-Ram) Flap for Chest Wall Reconstruction

“…This tumor represents a rare, locally aggressive soft tissue neoplasm, which is recognized as semimalignant with high tendency for local recurrence 7,8 . The 3-year and 5-year recurrence-free survival rates of this neoplasm were 82.5 and 78%, while the 5-year survival rate is greater than 98% 9,10 . The patient did not undergo adjuvant chemotherapy or radiotherapy.…”

Evolving strategies for management of desmoid tumor

“…45 Postsurgical relapse rates were higher for extra-abdominal DTs than for abdominal DTs and among juvenile patients versus adult patients, 46 and nomograms that incorporated tumor size Cancer August 15, 2022 to predict postsurgical recurrence were subsequently developed. 27,49 A recent Danish study reported that rates of surgery as initial DT treatment fell from 75% between 2009 and 2014 to 32% between 2015 and 2018. 50 Several factors have combined to unseat surgery as the de facto first-line standard treatment for most patients with DT.…”

“…Microscopically margin‐negative (R0) resections were not achieved in most surgeries, and there was no consensus on whether a positive margin resection correlated with the risk of recurrence 45 . Postsurgical relapse rates were higher for extra‐abdominal DTs than for abdominal DTs and among juvenile patients versus adult patients, 46 and nomograms that incorporated tumor size to predict postsurgical recurrence were subsequently developed 27,49 …”