Postoperative prognostic nomogram for adult grade II/III astrocytoma in the Chinese Han population

Lijie Wang; Jinling Zhang; Jingtao Wang; Hao Xue; Lin Deng; Fengyuan Che; Xueyuan Heng; Xuejun Zheng; Zilong Lu; Liuqing Yang; Qihua Tan; Yeping Xu; Yanchun Zhang; Xiaokang Ji; Gang Li; Fan Yang; Fuzhong Xue

doi:10.1007/s13755-023-00223-0

Postoperative prognostic nomogram for adult grade II/III astrocytoma in the Chinese Han population

Health Inf Sci Syst. 2023 May 4;11(1):23. doi: 10.1007/s13755-023-00223-0. eCollection 2023 Dec.

Authors

Lijie Wang^{1

2}, Jinling Zhang³, Jingtao Wang^{1

2}, Hao Xue^{4

5}, Lin Deng^{4

5}, Fengyuan Che⁶, Xueyuan Heng⁷, Xuejun Zheng⁸, Zilong Lu⁹, Liuqing Yang¹⁰, Qihua Tan^{11

12}, Yeping Xu¹³, Yanchun Zhang¹⁴, Xiaokang Ji², Gang Li^{4

5}, Fan Yang^{1

2}, Fuzhong Xue^{1

2}

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China.
² Institute for Medical Dataology, Shandong University, Jinan, China.
³ Cancer Center & the Research Center of Function Image on Brain Tumor, Linyi People's Hospital, Shandong University, Linyi, China.
⁴ Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China.
⁵ Institute of Brain and Brain-Inspired Science, Shandong Provincial Key Laboratory of Brain Function Remodeling, Shandong University, Jinan, China.
⁶ Neurology Department & the Research Center of Function Image on Brain Tumor, Linyi People's Hospital, Shandong University, Linyi, China.
⁷ Neurosurgery Department & the Research Center of Function Image on Brain Tumor, Linyi People's Hospital, Shandong University, Linyi, China.
⁸ Department of Radiology, Linyi People's Hospital, Shandong University, Linyi, China.
⁹ The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.
¹⁰ The Department for Chronic and Non-Communicable Disease and Endemic Disease Control and Prevention, Linyi Center for Disease Control and Prevention, Linyi, China.
¹¹ Epidemiology and Biostatistics, Department of Public Health, University of Southern Denmark, Odense, Denmark.
¹² Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹³ Synthesis Electronic Technology Co., Ltd., Jinan, China.
¹⁴ Institute for Sustainable Industries & Liveable Cities, College of Engineering and Science, Victoria University, Melbourne, VIC Australia.

PMID: 37151917
PMCID: PMC10160268 (available on 2024-12-01)
DOI: 10.1007/s13755-023-00223-0

Abstract

Background: Prognostic models of glioma have been the focus of many studies. However, most of them are based on Western populations. Additionally, because of the complexity of healthcare data in China, it is important to select a suitable model based on existing clinical data. This study aimed to develop and independently validate a nomogram for predicting the overall survival (OS) with newly diagnosed grade II/III astrocytoma after surgery.

Methods: Data of 472 patients with astrocytoma (grades II-III) were collected from Qilu Hospital as training cohort while data of 250 participants from Linyi People's Hospital were collected as validation cohort. Cox proportional hazards model was used to construct the nomogram and individually predicted 1-, 3-, and 5-year survival probabilities. Calibration ability, and discrimination ability were analyzed in both training and validation cohort.

Results: Overall survival was negatively associated with histopathology, age, subtotal resection, multiple tumors, lower KPS and midline tumors. Internal validation and external validation showed good discrimination (The C-index for 1-, 3-, and 5-year survival were 0.791, 0.748, 0.733 in internal validation and 0.754, 0.735, 0.730 in external validation, respectively). The calibration curves showed good agreement between the predicted and actual 1-, 3-, and 5-year OS rates.

Conclusion: This is the first nomogram study that integrates common clinicopathological factors to provide an individual probabilistic prognosis prediction for Chinese Han patients with astrocytoma (grades II-III). This model can serve as an easy-to-use tool to advise patients and establish optimized surveillance approaches after surgery.

Supplementary information: The online version contains supplementary material available at 10.1007/s13755-023-00223-0.

Keywords: Astrocytoma; Cox proportional hazards models; Nomograms; Prognosis; Survival.

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