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BMC Cancer

, 14:554

Epidemiology, prevention and public health

Abstract

BackgroundThe purpose of this study was to evaluate the survival outcome for middle ear cancer and to construct prognostic models to provide patients and clinicians with more accurate estimates of individual survival probability.

MethodsPatients diagnosed with middle ear cancer between 1983 and 2011 were selected for the study from the Surveillance Epidemiology and End Results Program. We used the Kaplan-Meier product limit method to describe overall survival and cause-specific survival. Cox proportional hazards models were fitted to model the relationships between patient characteristics and prognosis. Nomograms for predicting overall survival and cause-specific survival were built using the Cox models established.

ResultsThe entire cohort comprised 247 patients with malignant middle ear cancer. Median duration of follow-up until censoring or death was 25 months range, 1–319 months. Five-year overall survival and cause-specific survival were 47.4% 95% Confidence Interval CI, 41.2% to 54.6% and 58.0% 95% CI, 51.6% to 65.3%, respectively. In multivariable analysis, age, histological subtype, stage, surgery and radiotherapy were predictive of survival. The bootstrap corrected c-index for model predicting overall and cause-specific survival was 0.73 and 0.74, respectively. Calibration plots showed that the predicted survival reasonably approximated observed outcomes.

ConclusionThe models represent an objective analysis of all currently available data. The resulting models demonstrated good accuracy in predicting overall survival and cause-specific survival. Nomograms should thus be considered as a useful tool for predicting clinical prognosis.

KeywordsMiddle ear cancer Nomogram Overall survival Cause-specific survival AbbreviationsLHXLangerhans histocytosis X

SEERSurveillance epidemiology and end results

AJCCAmerican joint committee on cancer

RmsRegression modeling strategies

OSOverall survival

CSSCause-specific survival

AICAkaike information criterion

c-indexconcordance index

CIConfidence interval

IMRTIntensify-modulated radiation therapy

LLocalized

RRegional

DDistant

SSquamous cell carcinoma

AAdenocarcinoma

OOthers.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-14-554 contains supplementary material, which is available to authorized users.

Weidong Shen and Limin Yang contributed equally to this work.

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Autor: Weidong Shen - Naoko Sakamoto - Limin Yang

Fuente: https://link.springer.com/



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