Nomograms predict survival of patients with small bowel adenocarcinoma: a SEER-based study
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ORIGINAL ARTICLE
Nomograms predict survival of patients with small bowel adenocarcinoma: a SEER‑based study Zhibo Zheng1 · Xingtong Zhou2 · Jieshi Zhang1 · Bangbo Zhao3 · Chuyan Chen4 · Xudong Liu5 · Hongtao Cao3 · Tianhao Li3 · Ruixuan Geng1 · Weibin Wang3 · Yongning Li1 Received: 18 June 2020 / Accepted: 13 October 2020 © Japan Society of Clinical Oncology 2020
Abstract Background and objective Small bowel adenocarcinoma (SBA) is a rare malignant tumor with a poor prognosis. Most patients with SBA are diagnosed with advanced-stage disease. Due to the lack of randomized controlled trials and prospective studies, it is difficult to predict the prognosis of patients with SBA. Thus, this study aimed to establish a prognostic nomogram for evaluating the prognosis of SBA patients. Methods The clinical features and follow-up data of all patients diagnosed with SBA during 2004–2016 were summarized from the Surveillance, Epidemiology, and End Results (SEER) database. We separated these patients into training and validation groups. Multivariate Cox regression analyses were performed to identify independent prognostic variables for predicting cancer-specific survival (CSS) and overall survival (OS). According to the independent risk factors, we established nomograms and used the calibration curves to evaluate the accuracy. Results The data of 3301 patients with SBA were collected from the SEER database. The multivariate analysis showed that age, marital status, tumor site, grade, TNM stage and surgical history were associated with CSS and OS (P 0.7). The calibration curves showed that the predicted survival was very close to the actual survival. Conclusion We analyzed the independent risk factors for prognosis of SBA patients, and established nomograms to predict the 3- and 5-year survival rates of OS and CSS. These new prognostic tools can help clinicians to predict the survival of patients with SBA, further to guide treatment strategy. Keywords Small bowel adenocarcinoma · SEER database · Prognosis · Nomogram
Introduction The small bowel includes duodenum, jejunum, and ileum. The total area of the small intestinal mucosa account for as much as 90% of the entire gastrointestinal tract. However, small bowel tumors are very rare compared with other digestive tract tumors. Primary malignant tumors of the small bowel are even rarer, which account for less than 5% of all Zhibo Zheng and Xingtong Zhou have contributed to the work equally and should be regarded as co-first authors. * Weibin Wang [email protected] * Yongning Li [email protected] Extended author information available on the last page of the article
digestive tract tumors [1]. Among these primary malignant tumors of the small bowel, the small bowel adenocarcinoma (SBA) accounts for approximately 40%, and the incidence is still increasing year by year [2]. The most common site of SBA is the duodenum, followed by the jejunum and ileum [3, 4]. SBA patients are characterized by late diagnosis and poor prognosis. It is reported that the 5-year survival rate of
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