Risk factors identification for prognosis of ovarian cancer patients with lung metastasis and establishment of nomogram

YI Yanan; HAN Chongxu; LIANG Chengtong; YANG Mingyu; WANG Mengting

doi:10.7619/jcmp.20223123

Journal of Clinical Medicine in Practice > 2023 > 27(1): 1-8, 15. > DOI: 10.7619/jcmp.20223123

YI Yanan, HAN Chongxu, LIANG Chengtong, YANG Mingyu, WANG Mengting. Risk factors identification for prognosis of ovarian cancer patients with lung metastasis and establishment of nomogram[J]. Journal of Clinical Medicine in Practice, 2023, 27(1): 1-8, 15. DOI: 10.7619/jcmp.20223123

Citation:

PDF (3580 KB)

Risk factors identification for prognosis of ovarian cancer patients with lung metastasis and establishment of nomogram

1.
Department of Laboratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001
2.
School of Postgraduate of Dalian Medical University, Dalian, Liaoning, 116044
3.
Department of Obstetrics and Gynecology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225001

More Information

Received Date: October 16, 2022
Available Online: February 01, 2023

Graphical Abstract

Abstract

Abstract

Objective
To investigate the independent prognostic factors for ovarian cancer patients with lung metastases based on the Surveillance, Epidemiology and End Results Database (SEER) of the United States and to establish a survival prediction model.
Methods
Clinical data of 1 804 ovarian cancer patients diagnosed with lung metastases from 2010 to 2015 were collected, and they were divided into modeling set (1 203 cases) and validation set (601 cases) in a 2:1 ratio. Independent prognostic factors of ovarian cancer patients with lung metastasis were evaluated by Cox regression analysis and Nomogram prediction model was established. C index, receiver operating characteristic (ROC) curve and correction curve were used to evaluate the accuracy of the model.
Results
Multivariate Cox regression analysis showed that age>80 years old (HR=1.42; 95%CI, 1.15 to 1.76), moderately or poorly differentiated or undifferentiated tumor (HR=3.96, 4.24, 3.03; 95%CI, 1.21 to 12.98, 1.34 to 13.43, 0.95 to 9.70), Nx stage of N stage (HR=1.25; 95%CI, 1.06 to 1.47), ten positive lymph nodes or more (HR=1.44, 95%CI, 1.01 to 2.10), bone metastasis (HR=1.42; 95%CI, 1.10 to 1.83), liver metastasis (HR=1.28; 95%CI, 1.12 to 1.47), elevated CA125 (HR=1.89; 95%CI, 1.18 to 3.05) were independent risk factors for overall survival (P < 0.05). The epithelial type II of histological type (HR=0.70; 95%CI, 0.52 to 0.92), surgical R0 resection or other surgical methods (HR=0.40, 0.54, 95%CI, 0.31 to 0.51, 0.45 to 0.66), chemotherapy (HR=0.31, 95%CI, 0.26 to 0.36) and married status (HR=0.86, 95%CI, 0.75 to 0.99) were independent protective factors for overall survival (P < 0.05). Age>80 years old, no surgery, no chemotherapy, liver metastasis, bone metastasis, and elevated cancer antigen-125 (CA125) were independent risk factors for cancer-specific survival (P < 0.05). Nomogram prediction models were established for the overall survival rate and cancer-specific survival rate, and the C index of internal and external verification were 0.767, 0.761 and 0.750, 0.742, and the areas under the curve were 0.775, 0.783 and 0.749, 0.764, respectively.
Conclusion
Identifying the independent prognostic factors of patients with ovarian cancer with lung metastasis and establishing a quantitative Nomogram prediction model will help clinicians evaluate the prognosis more accurately.
- ovarian cancer,
- lung metastases,
- prognosis,
- Surveillance, Epidemiology and End Results Database,
- Nomogram,
- risk factors

FullText(HTML)

References (28)

References

[1]	FERLAY J, STELIAROVA-FOUCHER E, LORTET-TIEULENT J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012[J]. Eur J Cancer, 2013, 49(6): 1374-1403. doi: 10.1016/j.ejca.2012.12.027
[2]	SIEGEL R L, MILLER K D, JEMAL A. Cancer statistics, 2019[J]. CA A Cancer J Clin, 2019, 69(1): 7-34. doi: 10.3322/caac.21551
[3]	ZHANG M H, CHENG S S, JIN Y, et al. Roles of CA125 in diagnosis, prediction, and oncogenesis of ovarian cancer[J]. Biochim Biophys Acta BBA Rev Cancer, 2021, 1875(2): 188503. doi: 10.1016/j.bbcan.2021.188503
[4]	PROCACCIO L, BERGAMO F, MANAI C, et al. An overview on clinical, pathological and molecular features of lung metastases from colorectal cancer[J]. Expert Rev Respir Med, 2019, 13(7): 635-644. doi: 10.1080/17476348.2019.1620605
[5]	LUTZ S, NORRELL R, BERTUCIO C, et al. Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the Lung Cancer Symptom Scale in a community hospital[J]. J Palliat Med, 2001, 4(2): 157-165. doi: 10.1089/109662101750290191
[6]	BALACHANDRAN V P, GONEN M, SMITH J J, et al. Nomograms in oncology: more than meets the eye[J]. Lancet Oncol, 2015, 16(4): e173-e180. doi: 10.1016/S1470-2045(14)71116-7
[7]	XU J Q, HUSSAIN I, WANG L Y, et al. Incidence of and risk factors associated with lung metastases in newly diagnosed epithelial ovarian cancer with a look on prognosis after diagnosis: a population-based cohort study of the SEER database[J]. Arch Gynecol Obstet, 2021, 304(4): 1007-1020. doi: 10.1007/s00404-021-05997-w
[8]	YUAN Y F, GUO F F, WANG R R, et al. Development and validation of a nomogram to predict synchronous lung metastases in patients with ovarian cancer: a large cohort study[J]. Biosci Rep, 2020, 40(11): BSR20203089. doi: 10.1042/BSR20203089
[9]	PERES L C, CUSHING-HAUGEN K L, KÖBEL M, et al. Invasive epithelial ovarian cancer survival by histotype and disease stage[J]. J Natl Cancer Inst, 2019, 111(1): 60-68. doi: 10.1093/jnci/djy071
[10]	MATZ M, COLEMAN M P, SANT M, et al. The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)[J]. Gynecol Oncol, 2017, 144(2): 405-413. doi: 10.1016/j.ygyno.2016.10.019
[11]	KURMAN R J, SHIH I M. The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded[J]. Am J Pathol, 2016, 186(4): 733-747. doi: 10.1016/j.ajpath.2015.11.011
[12]	符伶俐, 韩江龙, 付振明. 年轻卵巢癌患者的临床特征及影响生存结局的因素: 一项人群队列回顾性研究[J]. 临床与病理杂志, 2021, 41(10): 2274-2284. doi: 10.3978/j.issn.2095-6959.2021.10.008
[13]	COOPER B C, SOOD A K, DAVIS C S, et al. Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer[J]. Obstet Gynecol, 2002, 100(1): 59-64.
[14]	MATTE I, GARDE-GRANGER P, BESSETTE P, et al. Ascites from ovarian cancer patients stimulates MUC16 mucin expression and secretion in human peritoneal mesothelial cells through an Akt-dependent pathway[J]. BMC Cancer, 2019, 19(1): 406. doi: 10.1186/s12885-019-5611-7
[15]	LEE M, CHANG M Y, YOO H, et al. Clinical significance of CA125 level after the first cycle of chemotherapy on survival of patients with advanced ovarian cancer[J]. Yonsei Med J, 2016, 57(3): 580-587. doi: 10.3349/ymj.2016.57.3.580
[16]	DU BOIS A, REUSS A, PUJADE-LAURAINE E, et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d'Investigateurs Nationaux Pour les Etudes des Cancers de l'Ovaire (GINECO)[J]. Cancer, 2009, 115(6): 1234-1244. doi: 10.1002/cncr.24149
[17]	KEYVER-PAIK M D, ABRAMIAN A, DOMRÖSE C, et al. Integrated care in ovarian cancer "IgV Ovar": results of a German pilot for higher quality in treatment of ovarian cancer[J]. J Cancer Res Clin Oncol, 2016, 142(2): 481-487. doi: 10.1007/s00432-015-2055-6
[18]	FRIEDRICH M, FRIEDRICH D, KRAFT C, et al. Multimodal treatment of primary advanced ovarian cancer[J]. Anticancer Res, 2021, 41(7): 3253-3260. doi: 10.21873/anticanres.15111
[19]	KAISER N C, HARTOONIAN N, OWEN J E. Toward a cancer-specific model of psychological distress: population data from the 2003-2005 National Health Interview Surveys[J]. J Cancer Surviv, 2010, 4(4): 291-302. doi: 10.1007/s11764-010-0120-3
[20]	SIN N L, DIMATTEO M R. Depression treatment enhances adherence to antiretroviral therapy: a meta-analysis[J]. ann behav med, 2014, 47(3): 259-269. doi: 10.1007/s12160-013-9559-6
[21]	COHEN S D, SHARMA T, ACQUAVIVA K, et al. Social support and chronic kidney disease: an update[J]. Adv Chronic Kidney Dis, 2007, 14(4): 335-344. doi: 10.1053/j.ackd.2007.04.007
[22]	AIZER A A, CHEN M H, MCCARTHY E P, et al. Marital status and survival in patients with cancer[J]. J Clin Oncol, 2013, 31(31): 3869-3876. doi: 10.1200/JCO.2013.49.6489
[23]	SATIN J R, LINDEN W, PHILLIPS M J. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis[J]. Cancer, 2009, 115(22): 5349-5361. doi: 10.1002/cncr.24561
[24]	GE L X, MORDIFFI S Z. Factors associated with higher caregiver burden among family caregivers of elderly cancer patients: a systematic review[J]. Cancer Nurs, 2017, 40(6): 471-478. doi: 10.1097/NCC.0000000000000445
[25]	KIM A, LEE J A, PARK H S. Health behaviors and illness according to marital status in middle-aged Koreans[J]. J Public Health (Oxf), 2018, 40(2): e99-e106. doi: 10.1093/pubmed/fdx071
[26]	FRANCESCHI C, CAPRI M, MONTI D, et al. Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans[J]. Mech Ageing Dev, 2007, 128(1): 92-105. doi: 10.1016/j.mad.2006.11.016
[27]	GARSSEN B, GOODKIN K. On the role of immunological factors as mediators between psychosocial factors and cancer progression[J]. Psychiatry Res, 1999, 85(1): 51-61. doi: 10.1016/S0165-1781(99)00008-6
[28]	SERRA-REXACH J A, JIMENEZ A B, GARCÍA-ALHAMBRA M A, et al. Differences in the therapeutic approach to colorectal cancer in young and elderly patients[J]. Oncologist, 2012, 17(10): 1277-1285. doi: 10.1634/theoncologist.2012-0060

Cited By

Get Citation

PDF

XML

Article views PDF downloads

Turn off MathJax

Article Contents

Abstract

References

Risk factors identification for prognosis of ovarian cancer patients with lung metastasis and establishment of nomogram

Abstract

References

Catalog

Export File

Citation

Format

Content