Prognostic nomogram in middle-aged and elderly patients with chordoma: A SEER-based study

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 32; no. 2; p. 10225536241254208
• Main Authors: Ouyang, Chenxi, Sun, Yu, Li, Yong, Jiang, Ming, Nong, Luming, Gao, Gongming
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-05-2024; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Bone Neoplasms - epidemiology; Bone Neoplasms - mortality; Bone Neoplasms - pathology; Bone Neoplasms - therapy; Chordoma - mortality; Chordoma - pathology; Chordoma - therapy; Female; Humans; Male; Medical prognosis; Middle age; Middle Aged; Nomograms; Prognosis; Proportional Hazards Models; SEER Program; Survival Rate; nomogram; cox multivariate analysis; chordoma; surveillance, epidemiology, and end result study
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/10225536241254208

Background
Chordoma is a bone tumor that tends to occur in middle-aged and elderly people. It grows relatively slowly but is aggressive. The prognosis of middle-aged and elderly patients with chordoma is quite different from that of young patients with chordoma.
Objectives
The purpose of the research was to construct a nomogram to predict the Individualized prognosis of middle-aged and elderly (age greater than or equal to 40 years) patients with chordoma.
Methods
In this study, we screened 658 patients diagnosed with chordoma from 1983 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. We determined the independently prognostic factors that affect the survival of patients by univariate and multivariate Cox proportional hazards model. Based on the independent prognostic factors, we constructed a nomogram to predict the overall survival (OS) rates of middle-aged and elderly patients with chordoma at 3 and 5 years. The validation of this nomogram was completed by evaluating the calibration curve and the C-index.
Results
We screened a total of 658 patients and divided them into two cohort. Training cohort had 462 samples and validation cohort had 196 samples. The multivariate Cox proportional hazards model of the training group showed an association of age, tumor size, histology, primary site, surgery, and extent of disease with OS rates. Based on these results, we constructed the corresponding nomogram. The calibration curve and C-index showed the satisfactory ability of the nomogram in terms of predictive ability.
Conclusion
Nomogram can be an effective prognostic tool to assess the prognosis of middle-aged and elderly patients with chordoma and can help clinicians in medical decision-making and enable patients to receive more accurate and reasonable treatment.