Build Prognostic Nomograms For Chordoma Based On A Multicenter Database

ObjectiveChordoma is an orphan and low-grade malignant bone tumor.The sectional clinical features and optimal treatment strategies are unclear and remain to be discussed.The study aims to discover some significant factors and build prognostic nomograms about chordoma.The novel nomograms aid to optimize clinical decision-making and improve prognosis of chordoma.MethodThe study was a retrospective multicenter study.The initial data cohort was concentrated form four medical centers of mainland China and all chordoma patients were received and cured before January 2015.Local relapse-free survival(LRFS)and overall survival(OS)were served as outcome indicators.The prognostic predictors were identified by the Lasso regression and Cox proportional hazards regression model.Then the nomograms were constructed.Their accuracy,calibration and discrimination were assessed by the Receiver Operating Characteristic curve(ROC),Calibration curve and C-index,respectively.ResultThe initial data cohort included 341 patients,and there were 276 patients which data information was unabridged and available.The analysis showed there were 179 patients(64.9%)experienced recurrence and 122 patients(44.2%)died of all causes and a median follow-up time was 57.5(range,1-325)months.Then,we found tumor location,tumor size,resection method and histology subtype were related to recurrence.While tumor size,tumor location,resection method,complication and postoperative recurrence were related to overall survival.Finally,two prognostic nomograms were constructed about LRFS and OS of chordoma.The calibration and discriminative ability were decent(C index 0.79 and 0.76,respectively).The ROCs suggested good prediction ability.the 5-year AUC value was 0.868 in LRFS nomogram and the 5-year AUC value was 0.786 in OS nomogram.ConclusionWe established two nomograms to predict the LRFS and OS of chordoma based on the multicenter case series from four medical centers.The nomograms could optimize clinical decision-making and provide extra prognostic information for risk stratification to improve prognosis of chordoma patients.