Postoperative Nomogram for 12-Year Sarcoma-Specific Death

Publication Type

Journal Article

Publication Date

2002

Abstract

Purpose: Few published studies have analyzed risk factors for sarcoma-specific death. We developed and internally validated a nomogram that combines the factors to predict the probability of 12-year sarcoma-specific death using a database of 2,136 prospectively followed adult patients treated at a single institution. Patients and Methods: Nomogram predictor variables included age at diagnosis, tumor size (? 5, 5 to 10, or > 10 cm), histologic grade (high or low), histologic subtype (fibrosarcoma, leiomyosarcoma, liposarcoma, malignant fibrous histiocytoma, malignant peripheral nerve tumor, synovial, or other), depth (superficial or deep), and site (upper extremity, lower extremity, visceral, thoracic or trunk, retrointraabdominal, or head or neck). Death from sarcoma or treatment complication was the predicted end point. Three prediction methods were compared, Kaplan-Meier analysis of all possible subsets, recursive partitioning, and Cox proportional hazards regression analysis. The concordance index was used as an accuracy measure with bootstrapping to correct for optimistic bias. Results: Sarcoma-specific death at 12 years was 36% (95% confidence interval, 33% to 39%). The bootstrap-corrected concordance indices were as follows: Kaplan-Meier, 0.69; recursive partitioning, 0.74; and Cox regression, 0.77. A nomogram was drawn on the basis of the Cox regression model. This nomogram was internally validated using bootstrapping and shown to have excellent calibration. Conclusion: A nomogram has been developed to predict 12-year sarcoma-specific death. This tool may be useful for patient counseling, follow-up scheduling, and clinical trial eligibility determination.

Discipline

Econometrics | Medicine and Health Sciences

Research Areas

Econometrics

Publication

Journal of Clinical Oncology

Volume

20

Issue

3

First Page

791

Last Page

796

ISSN

0732-183X

Identifier

10.1200/JCO.2002.20.3.791

Publisher

Lippincott Williams and Wilkins

Additional URL

https://doi.org/10.1200/JCO.2002.20.3.791

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