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. 2021 Jul 15:14:3517-3527.
doi: 10.2147/IJGM.S320643. eCollection 2021.

Nomograms for Predicting Overall Survival Among Patients with Craniopharyngiomas at Initial Diagnosis: A SEER Population-Based Analysis

Haibo Teng #  1 , Zhiyong Liu #  1 , Ouying Yan  2 , Wenbo He  1 , Danyang Jie  3 , Yuanwei Qie  4 , Jianguo Xu  1
Affiliations

Nomograms for Predicting Overall Survival Among Patients with Craniopharyngiomas at Initial Diagnosis: A SEER Population-Based Analysis

Haibo Teng et al. Int J Gen Med. .

Abstract

Background: Craniopharyngiomas (CPs) are relatively rare benign tumor located in the central nervous system (CNS). This study investigates the related risk factors of survival of craniopharyngiomas and develops a simple but detailed method predicting prognosis based on the Surveillance, Epidemiology, and End Results (SEER) database in order to improve the clinic management of CPs.

Methods: Between 2004 and 2017, 1213 patients diagnosed with craniopharyngiomas registered at the program and were included in the SEER-21 registry database. Overall survival (OS) curves were plotted with the Kaplan-Meier method and significance was determined by Log rank test. Single- and multiple-factor regression analyses were made using Cox proportional hazards model to identify independent predictors related to OS. Subsequently, we developed a nomogram with those factors to predict 3-, 5- and 10-year OS of craniopharyngiomas patients.

Results: We identified 1213 patients with craniopharyngioma. The OS rates at 3, 5, and 10 years after diagnosis were 89.1%, 86.2%, and 83%. Age, ethnicity, tumor size and radiation therapy were confirmed to be predictors correlating with OS at initial diagnosis. In multivariate analysis, we found that younger age (P<0.001), smaller tumor size (P<0.001), white ethnicity (P<0.001) and radiation therapy (P=0.004) were the factors that remained significantly associated with better survival. A nomogram was successfully constructed and validated by ROC, calibration plots and C-index of 0.773 (95% CI, 0.708-0.838).

Conclusion: The well-calibrated nomogram is the first clinical prediction model for predicting the prognosis for patients with craniopharyngiomas at initial diagnosis. Our study indicates that the surgical effect is not clear. Younger white patients with radiotherapy have a better prognosis, and the gross total resection (GTR) was not effective in prolonging the OS of a patient compared to no surgery and subtotal resection (STR).

Keywords: SEER; craniopharyngioma; nomogram; overall survival.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The flow chart of data process.
Figure 2
Figure 2
Kaplan–Meier curves for patients with CPs by different variates. (A) Age group, (B) histology, (C) ethnicity, (D) radiation, (E) gender, (F) tumor size, (G) surgery, (H) treatment.
Figure 3
Figure 3
Prediction model nomogram. For each indicator, a vertical line is drawn downward to determine the points, and the points are added together to yield the total points on the bottom, and a vertical line is drawn from that location down to the probability of survival of craniopharyngioma. The figure on this line indicates the predicted 3-, 5- and 10-year of overall survival. The model includes the 4 variables represented in the final prediction nomogram: age, ethnicity, size, radiation.
Figure 4
Figure 4
Calibration curve of the nomogram predicting (A) 3-year, (B) 10-year, and (C) 5-year OS patients with CPs.
Figure 5
Figure 5
ROC curve of the nomogram predicting 3-year, 5-year, and 10-year OS patients with CPs.
See this image and copyright information in PMC

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