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. 2014 Sep 5:14:654.
doi: 10.1186/1471-2407-14-654.

Prognostic model for predicting overall survival in children and adolescents with rhabdomyosarcoma

Limin Yang  1 , Tetsuya Takimoto, Junichiro Fujimoto
Affiliations

Prognostic model for predicting overall survival in children and adolescents with rhabdomyosarcoma

Limin Yang et al. BMC Cancer. .

Abstract

Background: The purpose of this study was to develop a prognostic model for the survival of pediatric patients with rhabdomyosarcoma (RMS) using parameters that are measured during routine clinical management.

Methods: Demographic and clinical variables were evaluated in 1679 pediatric patients with RMS registered in the Surveillance, Epidemiology, and End Results (SEER) program from 1990 to 2010. A multivariate Cox proportional hazards model was developed to predict median, 5-year and 10-year overall survival (OS). The Akaike information criterion technique was used for model selection. A nomogram was constructed using the reduced model after model selection, and was internally validated.

Results: Of the total 1679 patients, 543 died. The 5-year OS rate was 64.5% (95% confidence interval (CI), 62.1-67.1%) and the 10-year OS was 61.8% (95%CI, 59.2-64.5%) for the entire cohort. Multivariate analysis identified age at diagnosis, tumor size, histological type, tumor stage, surgery and radiotherapy as significantly associated with survival (p < 0.05). The bootstrap-corrected c-index for the model was 0.74. The calibration curve suggested that the model was well calibrated for all predictions.

Conclusions: This study provided an objective analysis of all currently available data for pediatric RMS from the SEER cancer registry. A nomogram based on parameters that are measured on a routine basis was developed. The nomogram can be used to predict 5- and 10-year OS with reasonable accuracy. This information will be useful for estimating prognosis and in guiding treatment selection.

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Figures

Figure 1
Figure 1
Flow chart for the creation of the Surveillance, Epidemiology, and End Results (SEER) data set.
Figure 2
Figure 2
Nomogram for predicting 5- and 10-year overall survival and median survival time. Instructions: Locate the patient’s characteristic on the variable row, draw a vertical line straight upward to the points row to obtain a points value for the variable. Move to the next row of variables, and repeat this process to get points for each variable. Sum the total points and drop a vertical line from the total points row to assign the values for overall survival rates.
Figure 3
Figure 3
Calibration plot. (A) Five-year overall survival; (B) 10-year overall survival. The grey line is the “ideal” line if there is a perfect match between predicted and observed survivals. Vertical arrows represent 95% confidence intervals of observed survival. Dots correspond to apparent predictive accuracy. X marks the bootstrap-corrected estimates.
See this image and copyright information in PMC

References

    1. Miller RW, Young JL, Jr, Novakovic B. Childhood cancer. Cancer. 1995;75(1 Suppl):395–405. doi: 10.1002/1097-0142(19950101)75:1+<395::AID-CNCR2820751321>3.0.CO;2-W. - DOI - PubMed
    1. Ries L, Smith M, Gurney J, Linet M, Tamra T, Young J, Bunin G. Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975–1995. Bethesda, MD: National Cancer Institute, SEER Program; 1999.
    1. Crist W, Gehan EA, Ragab AH, Dickman PS, Donaldson SS, Fryer C, Hammond D, Hays DM, Herrmann J, Heyn R, Jones PM, Lawrence W, Newton W, Ortega J, Raney RB, Ruymann FB, Tefft M, Webber B, Wiener E, Wharam M, Vietti TJ, Maurer HM. The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol. 1995;13(3):610–630. - PubMed
    1. Pappo AS, Shapiro DN, Crist WM, Maurer HM. Biology and therapy of pediatric rhabdomyosarcoma. J Clin Oncol. 1995;13(8):2123–2139. - PubMed
    1. Surveillance, Epidemiology, and End Results (SEER) Program SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2011 Sub (1973–2010) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969–2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch,released April 2013, based on the November 2012 submission. [http://www.seer.cancer.gov]
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/654/prepub