Analysis Of Factors Affecting The Prognosis Of Patients With Osteosarcoma And The Construction Of A Survival Prediction Model

ObjectiveAnalyzing the factors affecting the prognosis of patients with osteosarcoma and establish nomograms to predict their 1-year,3-year,5-year overall survival rate and cancer-specific survival rateMaterials and MethodsAn analysis was conducted of 849 cases of osteosarcoma collected from the Surveillance,Epidemiology,and End Results(SEER)database between 2010 and 2015.Recording the patient’s sex,age,race,marital status,diagnosis method,tumor primary site,tumor size,pathological grade,tumor metastasis status,surgical information,radiotherapy and chemotherapy information,survival time,survival and death information,etc.The selected osteosarcoma patients are divided into the test group and the control group at a ratio of 7:3 by the random number table method.Setting cut-off values for continuous variables such as age and tumor size of patients with osteosarcoma through the X-tile software.Kaplan-Meier analysis and Log-rank test are used to show the overall survival rate and cancer-specific survival rate of patients under different clinicopathological factors;stratified analysis is used to study the effect of chemotherapy on the survival rate of patients with osteosarcoma in certain subgroups;the Univariate Cox proportional hazard regression model and the multivariate Cox proportional hazard regression model are used to calculate the hazard ratio and 95%confidence interval,and determine independent risk factors that affect the overall survival and cancer-specific survival of patients with osteosarcoma.The independent risk factors identified in the multivariate Cox proportional hazards regression model are included and the nomograms of the patients’ 1-year,3-year and 5-year overall survival rates and cancer-specific survival rates were drawn respectively.Using external and internal verification methods to verify the nomograms,calculating the C-index,and drawing calibration curves.ResultsThe results of univariate and multivariate Cox regression analysis showed that age,primary site,pathological grade,tumor size,metastasis,and surgery are independent risk factors affecting the overall survival rate and cancer-specific survival rate of patients with osteosarcoma.They are included and constructed to predict the 1-year,3-year,5-year overall survival rate and cancer-specific survival rate of patients with osteosarcoma,respectively.The Bootstrap method is used for internal and external verification of the constructed nomograms.The C-indexes of the nomograms for predicting overall survival and cancer-specific survival in the internal verification were 0.796(95%CI:0.762-0.830)and 0.803(95%CI:0.747-0.858),respectively,and the C-indexes of the external verification are 0.802(95%CI:0.768-0.835)and 0.832(95%CI:0.779-0.884),respectively.The calibration curves obtained by internal and external verification also show that there is an excellent consistency between the survival rate predicted by the model and the actual survival rate.ConclusionsThe nomograms established in this study for predicting the overall survival and cancer-specific survival of patients with osteosarcoma have high prediction accuracy,which can provide accurate and individualized predictions for the survival of patients with osteosarcoma,and help clinicians make an individualized treatment plan for patients.