Risk factor analysis and nomogram establishment and verification of brain astrocytoma patients based on SEER database

Abstract

Astrocytoma is a common brain tumor that can occur in any part of the central nervous system. This tumor is extremely harmful to patients, and there are no clear studies on the risk factors for astrocytoma of the brain. This study was conducted based on the SEER database to determine the risk factors affecting the survival of patients with astrocytoma of the brain. Patients diagnosed with brain astrocytoma in the SEER database from 2004 to 2015 were screened by inclusion exclusion criteria. Final screened brain astrocytoma patients were classified into low grade and high grade according to WHO classification. The risk factors affecting the survival of patients with low-grade and high-grade brain astrocytoma were analyzed by univariate Kaplan–Meier curves and log-rank tests, individually. Secondly, the data were randomly divided into training set and validation set according to the ratio of 7:3, and the training set data were analyzed by univariate and multivariate Cox regression, and the risk factors affecting the survival of patients were screened and nomogram was established to predict the survival rates of patients at 3 years and 5 years. The area under the ROC curve (AUC value), C-index, and Calibration curve are used to evaluate the sensitivity and calibration of the model. Univariate Kaplan–Meier survival curve and log-rank test showed that the risk factors affecting the prognosis of patients with low-grade astrocytoma included Age, Primary site, Tumor histological type, Grade, Tumor size, Extension, Surgery, Radiation, Chemotherapy and Tumor number; risk factors affecting the prognosis of patients with high-grade astrocytoma include Age, Primary site, Tumor histological type, Tumor size, Extension, Laterality, Surgery, Radiation, Chemotherapy and Tumor number. Through Cox regression, independent risk factors of patients with two grades were screened separately, and nomograms of risk factors for low-grade and high-grade astrocytoma were successfully established to predict the survival rate of patients at 3 and 5 years. The AUC values of low-grade astrocytoma training set patients were 0.829 and 0.801, and the C-index was 0.818 (95% CI 0.779, 0.857). The AUC values of patients in the validation set were 0.902, 0.829, and the C-index was 0.774 (95% CI 0.758, 0.790), respectively. The AUC values of high-grade astrocytoma training set patients were 0.814 and 0.806, the C-index was 0.774 (95% CI 0.758, 0.790), the AUC values of patients in the validation set were 0.802 and 0.823, and the C-index was 0.766 (95% CI 0.752, 0.780), respectively, and the calibration curves of the two levels of training set and validation set were well fitted. This study used data from the SEER database to identify risk factors affecting the survival prognosis of patients with brain astrocytoma, which can provide some guidance for clinicians.

Risk factors for secondary thyroid cancer in patients with breast cancer : a propensity‑matched SEER analysis

“…It is suggested that the column-line diagram has good predictive ability for the risk of secondary thyroid cancer in breast cancer patients 3 and 5 years after the onset of the disease. However, since the data were obtained from the United States, more studies are needed to verify whether the results obtained by applying this data can be applied to the Chinese population, and the results of this study can provide some references for clinicians [14] .…”

“…The area under the ROC curve (AUC value) and C-index were used to evaluate the accuracy of the model, the AUC and C-index range from 0-1, the closer to 1 indicates that the model is more accurate, and it is usually considered that the model has a better predictive ability when the AUC reaches more than 0.7; the calibration curve was used to evaluate the degree of calibration of the model, and the closer the calibration curve is to the standard curve, the stronger the predictive ability of the model. Variables with a one-way COX regression of P < 0.1 were included in the multifactor analysis, and the multifactor analysis was included in the nal model with the criterion that the difference was considered statistically signi cant at P < 0.05 [14] .…”