Nomograms for predicting long-term overall survival and cancer-specific survival in patients with primary urethral carcinoma: a population-based study

Int Urol Nephrol. 2020 Feb;52(2):287-300. doi: 10.1007/s11255-019-02314-y. Epub 2019 Oct 14.

Abstract

Background: Our aim was to identify the independent prognostic factors in patients with primary urethral carcinoma (PUC) and to predict their overall survival (OS) and cancer-specific survival (CSS) at 3, 5, and 8 years.

Methods: Patients with PUC identified in the Surveillance, Epidemiology, and End Results (SEER) database were divided into training and validation cohorts. Nomograms were constructed based on the results of Cox regression analysis. The predictive performance of each nomogram was evaluated using the consistency index (C-index), the area under the receiver operating characteristics curve (AUC), and calibration plots. Decision-curve analysis (DCA) was used to test the clinical value of the predictive models.

Results: Our study screened 822 patients with PUC. Multivariate analysis showed that the age at diagnosis, race, histology, American Joint Committee on Cancer (AJCC) stage, and surgery status were independent prognostic factors for CSS and age at diagnosis, race, histology, AJCC stage, surgery status, and chemotherapy for OS (all P < 0.05). We used these prognostic factors to construct nomograms. The C-indexes for OS and CSS were 0.713 and 0.741 in training cohorts and 0.714 and 0.738 in validation cohorts, respectively. The AUC and calibration plots demonstrated the good performance of both nomograms. The DCA indicated the presence of clinical net benefits in both the training and validation cohorts.

Conclusion: We developed and validated nomograms for predicting OS and CSS in patients with PUC, which can help clinicians make treatment decisions.

Keywords: Cancer-specific survival; Nomogram; Overall survival; Primary urethral carcinoma; SEER.

Publication types

  • Validation Study

MeSH terms

  • Adenocarcinoma / mortality*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Age Factors
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Area Under Curve
  • Black or African American / statistics & numerical data
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Carcinoma, Transitional Cell / mortality*
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / therapy
  • Female
  • Humans
  • Male
  • Neoplasm Staging
  • Nomograms*
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • SEER Program
  • Survival Rate
  • Time Factors
  • United States / epidemiology
  • Urethral Neoplasms / mortality*
  • Urethral Neoplasms / pathology
  • Urethral Neoplasms / therapy
  • White People / statistics & numerical data

Substances

  • Antineoplastic Agents