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Risk Factors, Prognostic Factors, and Nomograms for Bone Metastasis in Patients with Newly Diagnosed Clear Cell Renal Cell Carcinoma: A Large Population-Based Study

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单位: [1]Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Urol, Shanghai, Peoples R China [2]Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Orthoped, Shanghai, Peoples R China [3]Tongji Univ, Sch Med, Spinal Pain Res Inst, Shanghai, Peoples R China [4]Tongji Univ, Shanghai Tongji Hosp, Sch Med, Shanghai, Peoples R China [5]Tongji Univ, Sch Med, Shanghai East Hosp, Shanghai, Peoples R China [6]Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Natl Key Clin Pain Med China, Shenzhen, Peoples R China [7]Shenzhen Univ, Sch Biomed Engn, Hlth Sci Ctr, Guangdong Key Lab Biomed Measurements & Ultrasoun, Shenzhen, Peoples R China [8]Shenzhen Univ, Hlth Sci Ctr, Affiliated Hosp 6, Dept Pain Med, Shenzhen, Peoples R China [9]Shenzhen Univ, Hlth Sci Ctr, Affiliated Hosp 6, Shenzhen Municipal Key Lab Pain Med, Shenzhen, Peoples R China
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关键词: clear cell renal cell carcinoma bone metastasis SEER prognostic factors nomograms

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Background:& nbsp;This study aimed to investigate risk factors and prognostic factors in patients with clear cell renal cell carcinoma (ccRCC) with bone metastasis (BM) and establish nomograms to provide a quantitative prediction of the risk of BM and survival probability.Methods:& nbsp;The clinicopathological characteristics of patients with ccRCC between January 2010 and December 2015 were obtained from the Surveillance, Epidemiology and End Results (SEER) database. Independent factors for BM in ccRCC patients were identified using univariate and multivariate logistic regression analyses. Prognostic factors for predicting cancer-specific death were evaluated using univariate and multivariate analyses based on a competing risk regression model. We then constructed a diagnostic nomogram and a prognostic nomogram. The two nomograms were evaluated using calibration curves, receiver operating characteristic curves, and decision curve analysis.Results: Our study included 34,659 patients diagnosed with ccRCC in the SEER database, with 1,415 patients who presented with bone metastasis. Risk factors for BM in patients with ccRCC included age, stage T, stage N, brain metastasis, liver metastasis, lung metastasis, tumor size, and laterality. Independent prognostic factors for patients with ccRCC patients with BM were Fuhrman grade, tumor size, T stage, N stage, brain metastases, lung metastasis, and surgery. For the diagnostic nomogram, the area under the curve values in the training and testing cohorts were 0.863 (95% CI, 0.851-0.875) and 0.859 (95% CI, 0.839-0.878), respectively. In the prognostic cohort, the area under the curve values for 1-, 2-, and 3-year cancer-specific survival rates in the training cohort were 0.747, 0.774, and 0.780, respectively, and 0.671, 0.706, and 0.696, respectively, in the testing cohort. Through calibration curves and decision curve analyses, the nomograms displayed excellent performance.Conclusions: Several factors related to the development and prognosis of BM in patients with ccRCC were identified. The nomograms constructed in this study are expected to become effective and precise tools for clinicians to improve cancer management.

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大类 | 3 区 医学
小类 | 3 区 外科
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大类 | 4 区 医学
小类 | 4 区 外科
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Q2 SURGERY
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Q2 SURGERY

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第一作者单位: [1]Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Urol, Shanghai, Peoples R China
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通讯机构: [6]Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Natl Key Clin Pain Med China, Shenzhen, Peoples R China [7]Shenzhen Univ, Sch Biomed Engn, Hlth Sci Ctr, Guangdong Key Lab Biomed Measurements & Ultrasoun, Shenzhen, Peoples R China [8]Shenzhen Univ, Hlth Sci Ctr, Affiliated Hosp 6, Dept Pain Med, Shenzhen, Peoples R China [9]Shenzhen Univ, Hlth Sci Ctr, Affiliated Hosp 6, Shenzhen Municipal Key Lab Pain Med, Shenzhen, Peoples R China
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