Nomogram predict relapse-free survival of patients with thymic epithelial tumors after surgery

BMC Cancer. 2021 Jul 22;21(1):847. doi: 10.1186/s12885-021-08585-y.

Abstract

Background: Hematological indicators and clinical characteristics play an important role in the evaluation of the progression and prognosis of thymic epithelial tumors. Therefore, we aimed to combine these potential indicators to establish a prognostic nomogram to determine the relapse-free survival (RFS) of patients with thymic epithelial tumors undergoing thymectomy.

Methods: This retrospective study was conducted on 156 patients who underwent thymectomy between May 2004 and August 2015. Cox regression analysis were performed to determine the potential indicators related to prognosis and combine these indicators to create a nomogram for visual prediction. The prognostic predictive ability of the nomogram was evaluated using the consistency index (C-index), receiver operating characteristic (ROC) curve, and risk stratification. Decision curve analysis was used to evaluate the net benefits of the model.

Results: Preoperative albumin levels, neutrophil-to-lymphocyte ratio (NLR), T stage, and WHO histologic types were included in the nomogram. In the training cohort, the nomogram showed well prognostic ability (C index: 0.902). Calibration curves for the relapse-free survival (RFS) were in good agreement with the standard lines in training and validation cohorts.

Conclusions: Combining clinical and hematologic factors, the nomogram performed well in predicting the prognosis and the relapse-free survival of this patient population. And it has potential to identify high-risk patients at an early stage. This is a relatively novel approach for the prediction of RFS in this patient population.

Keywords: Albumin; Nomogram; Overall survival; Ratio of neutrophils to lymphocytes; Thymic epithelial tumor.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Disease Management
  • Female
  • Follow-Up Studies
  • Humans
  • Leukocyte Count
  • Lymphocytes
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Neoplasms, Glandular and Epithelial / diagnosis
  • Neoplasms, Glandular and Epithelial / mortality*
  • Neoplasms, Glandular and Epithelial / surgery
  • Neutrophils
  • Nomograms
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Thymectomy / methods
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / mortality*
  • Thymus Neoplasms / surgery
  • Treatment Outcome

Substances

  • Biomarkers

Supplementary concepts

  • Thymic epithelial tumor