Multivariate Analysis Of Prognosis Of Bladder Adenocarcinoma Based On SEER Database And Construction Of Nomogram

BackgroundBladder adenocarcinoma is one of the rare subtypes of bladder tumor disease,the incidence is lower than urothelial carcinoma and squamous cell carcinoma of the bladder,and ranks the third,accounting for about 2%.Due to the low incidence of bladder adenocarcinoma,there is a lack of sufficient sample data for clinical study and analysis.Therefore,the prognostic factors and treatment methods of this disease are controversial.Thus we use SEER database for the survival prognosis of bladder adenocarcinoma to study the related factors and treatment methods,at the same time can build individual nomogram of bladder adenocarcinoma patients survival prognosis model,which help clinicians according to different stage bladder adenocarcinoma patients choose individualized treatment and analysis of the survival of patients prognosis.ObjectiveBy analyzing independent prognostic risk factors of Adenocarcinoma of The Bladder(ACB),a histograph model was established to predict The survival and prognosis of patients with Bladder cancer individually.methodsCollected from the National Cancer Institute,National Cancer Institute)of the SEER database(the Surveillance,epidemiology and end results database,SEER)in 2600 cases during 2004-2015 were diagnosed with bladder adenocarcinoma patients clinical data filtering,the database is a collection of about 30% of the population of the United States in detail the Cancer diagnosis,treatment and survival data information,including Cancer patients with complete clinical data,With high representativeness and reliability,a total of 659 patients with bladder adenocarcinoma who met the research conditions were selected for retrospective analysis.All variables were brought into the Cox proportional regression risk model for univariate regression analysis using Empower Stat software.0.05 variables into Cox proportion model of risk to multiple factors regression analysis,using R language will Cox regression analysis of multiple factors determine the nomogram independent prognostic risk factors to build into a survival model,by using the Bootstrap method with equal 1 000 times back repeatedly sampling to verify this model,the C-index and nomogram calibration curve drawing to verify the accuracy of the models.resultsOur study found that age >;70 years old,tumor diameter >3 cm,no surgical treatment,patient’s pathological type,stage T3,T4,N1,N2 and M1 were independent risk factors affecting the survival time of patients.Meanwhile,the calibration curve of the histogram model established by us has a high consistency with the ideal curve,with a C-index of 0.74,which is highly applicable and accurate after internal verification.conclusionWe build the bladder adenocarcinoma nomogram model has high accuracy and applicability,for clinical doctors to assess and predict survival outcomes for patients with different individuals provides a convenient and intuitive tool,at the same time under the trend of current pursuit of precision medical,this model can be for clinicians to assess high-risk patients and provide reference for individualized health strategies and help.