A competing risk-based nomogram to predict cancer-specific survival in patients with retroperitoneal leiomyosarcoma

Qian Fang; Guojing Cai; Guizeng Chen; Xiang Xu; Haifeng Zeng; Yulong He; Shirong Cai; Hui Wu

doi:10.1016/j.heliyon.2023.e16867

A competing risk-based nomogram to predict cancer-specific survival in patients with retroperitoneal leiomyosarcoma

Heliyon. 2023 Jun 1;9(6):e16867. doi: 10.1016/j.heliyon.2023.e16867. eCollection 2023 Jun.

Authors

Qian Fang¹, Guojing Cai¹, Guizeng Chen¹, Xiang Xu¹, Haifeng Zeng¹, Yulong He¹, Shirong Cai¹, Hui Wu¹

Affiliation

¹ Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.

Abstract

Considering the rarity and aggressive nature of retroperitoneal leiomyosarcoma (RLMS), several prognostic factors might contribute to the cancer-specific mortality of these patients. This study aimed to construct a competing risk-based nomogram to predict cancer-specific survival (CSS) for patients with RLMS. In total, 788 cases from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2015) were included. Based on the Fine & Gray's method, independent predictors were screened to develop a nomogram for predicting 1-, 3-, and 5-year CSS. After multivariate analysis, CSS was found significantly associated with tumor characteristics (tumor grade, size, range), as well as surgery status. The nomogram showed solid prediction power and was well calibrated. Through decision curve analysis (DCA), a favorable clinical utility of the nomogram was demonstrated. Additionally, a risk stratification system was developed and distinctive survival between risk groups was observed. In summary, this nomogram showed a better performance than the AJCC 8th staging system and can assist in the clinical management of RLMS.

Keywords: Nomogram; Prognosis; Retroperitoneal leiomyosarcoma; Risk stratification system.