The clinicopathological characteristics of elderly endometrial carcinoma and establishment and validation of prognostic nomogram based on the SEER database
Objective To analyze the clinicopathological characteristics and prognostic risk factors of endometrial carcinoma in the elderly,construct a nomogram and verify it.Methods The retrospective cohort study was conducted.The eligible endometrial cancer cases from 2010 to 2019 in the Surveillance,Epidemiology and End Result(SEER)database were collected.All cases were divided into two groups(age≥60,age<60),and the differences of clinical and pathological characteristics were analyzed.Cox regression analysis was used to explore the prognostic risk factors of endometrial cancer in the elderly.On this basis,a prognostic nomogram model for predicting 3-year and 5-year overall survival rates was constructed and validated internally,and its reliability was evaluated by the consistency index(C-index),receiver operating characteristic(ROC)curve and calibration curve.Results A total of 21 446 patients were screened,including 8559 patients(39.91%)under 60 years old and 12 887 patients(60.09%)over 60 years old.There were significant differences between the two groups in terms of race,pathological type,histological grade,stage,operation mode,radiotherapy,chemotherapy,overall survival rate and cancer specific survival rate(P<0.05).Age,special pathological type(serous carcinoma,mixed carcinoma,carcinosarcoma,clear cell carcinoma),grade,stage,operation mode,chemotherapy and distant metastasis were independent risk factors of elderly endometrial carcinoma(P<0.05).A nomogram was constructed,the predicted C-indices for overall survival was 0.839(95%CI:0.834-0.843).The area under the curve of ROC of 3-year and 5-year overall survival rates were 0.864 and 0.847 respectively.Conclusion The elderly endometrial carcinoma had unique clinicopathological characteristics.The nomogram based on prognostic risk factors has good consistency and accuracy,which can be used as a reference to judge prognosis and guide treatment.
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