Development and external validation of dual online tools for prognostic assessment in elderly patients with high-grade glioma: a comprehensive study using SEER and Chinese cohorts

Front Endocrinol (Lausanne). 2023 Nov 21:14:1307256. doi: 10.3389/fendo.2023.1307256. eCollection 2023.

Abstract

Background: Elderly individuals diagnosed with high-grade gliomas frequently experience unfavorable outcomes. We aimed to design two web-based instruments for prognosis to predict overall survival (OS) and cancer-specific survival (CSS), assisting clinical decision-making.

Methods: We scrutinized data from the SEER database on 5,245 elderly patients diagnosed with high-grade glioma between 2000-2020, segmenting them into training (3,672) and validation (1,573) subsets. An additional external validation cohort was obtained from our institution. Prognostic determinants were pinpointed using Cox regression analyses, which facilitated the construction of the nomogram. The nomogram's predictive precision for OS and CSS was gauged using calibration and ROC curves, the C-index, and decision curve analysis (DCA). Based on risk scores, patients were stratified into high or low-risk categories, and survival disparities were explored.

Results: Using multivariate Cox regression, we identified several prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in elderly patients with high-grade gliomas, including age, tumor location, size, surgical technique, and therapies. Two digital nomograms were formulated anchored on these determinants. For OS, the C-index values in the training, internal, and external validation cohorts were 0.734, 0.729, and 0.701, respectively. We also derived AUC values for 3-, 6-, and 12-month periods. For CSS, the C-index values for the training and validation groups were 0.733 and 0.727, with analogous AUC metrics. The efficacy and clinical relevance of the nomograms were corroborated via ROC curves, calibration plots, and DCA for both cohorts.

Conclusion: Our investigation pinpointed pivotal risk factors in elderly glioma patients, leading to the development of an instrumental prognostic nomogram for OS and CSS. This instrument offers invaluable insights to optimize treatment strategies.

Keywords: SEER; cancer-specific survival; external validation; high-grade glioma; overall survival; web-based prognostic nomogram.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian People
  • China / epidemiology
  • Glioma* / diagnosis
  • Glioma* / therapy
  • Humans
  • Nomograms*
  • Prognosis

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by LncRNAs and miRNAs regulate the apoptosis of glioma cells (201900007), the roles of LncRNAs and PAK in glioblastoma cell proliferation and temozolomide resistant glioblastoma, Comparison of stereotactic intracranial hematoma puncture and aspiration combined with urokinase (20220016), the General Project of the Torch Program of the Fourth Affiliated Hospital of Harbin Medical University (HYDSYHJ201902) and the Special Support Project of the Fourth Affiliated Hospital of Harbin Medical University (HYDSYTB202232).