Development and validation of a survival prediction model for non-metastatic primary osteosarcoma-a study based on the SEER database
CAO Zheng-yi
Aizeizi·Aihaiti
WANG Jie
WANG Zhi-gang
Abstract：Objective To analyze the prognostic factors related to non-metastatic primary osteosarcoma based on the SEER database,and to establish and validate a survival prediction model for patients with non-metastatic primary osteosarcoma.Methods Retrospectively analyze the data of patients with pathological diagnosis of osteosarcoma and primary,non-metastatic in SEER database from 2000-2019,exclude some patients by exclusion criteria,define the outcome event as all-cause death,and chronologically divide the overall into the modeling group in 2004-2009 and the validation group in 2010-2015.The cross-validation LASSO(least absolute shrinkage and selection operator)regression was used to screen variables,and the screened variables were included in a multifactor COX regression analysis to identify factors independently associated with the outcome event,and to establish and validate a survival prediction model for non-metastatic primary osteosarcoma.Total patient scores were calculated based on column-line plots,and the best cutoff values were differentiated using X-tile software to classify the overall population into low,medium,and high risk groups for K-M survival analysis.Results The age:age 40-59 years vs.age≤19 years,HR 2.076,95%CI(1.467-2.983),(P＜0.001);age≥60 years old vs.age≤19 years,HR 2.996,95%CI(1.904-4.731),(P＜0.001).Grade Ⅲ vs.Grade Ⅰ,HR 3.514,95%CI(1.514-8.153),(P=0.003).Grade Ⅳvs.Grade Ⅰ,HR 2.914,95%CI(1.272-6.675),(P=0.011).Staging-regional vs.localized,HR 1.603,95%CI(1.198-2.145),(P=0.001).Non-surgical vs.surgical,HR 2.166,95%CI(1.293-3.629),(P=0.003).Variables independently associated with survival prognosis were determined as the age,grade,stage,and surgery,and nomogram was constructed to calculate the time-AUC values for N-fold k-fold cross-validation for the modeling group and the time-AUC values for the validation group.The result as 75%was greater than 0.7,which suggested that the model had good differentiation.The 1,3,5-year calibration curves of the modeling and validation groups were plotted,suggesting that the prediction had a high degree of agreement with the actual.The nomogram total score was calculated for each patient,and the best cutoff value was classified using X-tile software to divide the overall group into low-risk group(0-121 points),medium-risk group(130-135 points),and high-risk group(139-256 points).The K-M analysis of the 3 groups showed statistically significant differences in survival,P＜0.0001.Conclusions Survival prognosis analysis of non-metastatic primary osteosarcoma using the SEER database establishes a 1,3,5-year survival prediction model,and the use of the model helps to clinically calculate the survival rate in order to enhance management and further improve the prognosis.
Keywords：OsteosarcomaModelsforecastingPrognosisNomogramsPrimaryNon-metastatic
Publication Date：2025-02-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 120-128 )