Luo Tianlong, Hu Jintao, Cheng Bisheng, Chen Peixian, Fu Jianhan, Zhong Haitao, Han Jinli, Huang Hai
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen University, Guangzhou, China.
World J Mens Health. 2025 Apr;43(2):415-427. doi: 10.5534/wjmh.240061. Epub 2024 Jul 31.
Neuroendocrine prostate cancer (NEPC) represents a particularly aggressive subtype of prostate cancer with a challenging prognosis. The purpose of this investigation is to craft and confirm the reliability of nomograms that can accurately forecast the 1-, 3-, and 5-year overall survival (OS) and cancer-specific survival (CSS) rates for individuals afflicted with NEPC.
Data pertaining to patients diagnosed with NEPC within the timeframe of 2010 to 2020 was meticulously gathered and examined from the Surveillance, Epidemiology, and End Results Program (SEER). To predict OS and CSS, we devised and authenticated two distinct nomograms, utilizing predictive variables pinpointed through both univariate and multivariate Cox regression analyses.
The study encompassed 393 of NEPC patients, who were systematically divided into training and validation cohorts at a 2:1 ratio. Key prognostic factors were isolated, verified, and integrated into the respective nomograms for OS and CSS. The performance metrics, denoted by C-indices, stood at 0.730, 0.735 for the training set, and 0.784, 0.756 for the validation set. The precision and clinical relevance of the nomograms were further corroborated by the analysis of receiver operating characteristic curves, calibration plots, and decision curve analyses.
The constructed nomograms have demonstrated impressive efficacy in forecasting the 1-, 3-, and 5-year OS and rates for patients with NEPC. Implementing these predictive tools in clinical settings is anticipated to considerably enhance the care and treatment planning for individuals diagnosed with this aggressive form of prostate cancer, thus providing tailored and more precise prognostic assessments.
神经内分泌前列腺癌(NEPC)是前列腺癌中一种特别侵袭性的亚型,预后具有挑战性。本研究的目的是构建并验证列线图的可靠性,该列线图能够准确预测患有NEPC的个体的1年、3年和5年总生存率(OS)和癌症特异性生存率(CSS)。
从监测、流行病学和最终结果计划(SEER)中精心收集并检查了2010年至2020年期间被诊断为NEPC的患者的数据。为了预测OS和CSS,我们设计并验证了两个不同的列线图,利用通过单变量和多变量Cox回归分析确定的预测变量。
该研究纳入了393例NEPC患者,他们被系统地以2:1的比例分为训练组和验证组。确定、验证了关键预后因素,并将其纳入OS和CSS各自的列线图中。训练集的C指数表示的性能指标分别为0.730、0.735,验证集的为0.784、0.756。受试者工作特征曲线、校准图和决策曲线分析进一步证实了列线图的准确性和临床相关性。
构建的列线图在预测NEPC患者的1年、3年和5年OS及生存率方面显示出令人印象深刻的效果。预计在临床环境中应用这些预测工具将大大加强对诊断为这种侵袭性前列腺癌形式的个体的护理和治疗规划,从而提供量身定制且更精确的预后评估。