Analysis of prognostic factors influencing the prognosis of elderly chondrosarcoma patients by drawing column-line diagrams based on SEER database
Objective Chondrosarcoma is the second most common primary malignant tumour of the bone,and the most common one in the elderly with poor prognosis.The aim of this study is to construct a column chart to study the characteristics and prognostic factors of elderly patients with chondrosarcoma.Methods Data were extracted from the Surveillance,Epidemiology,and End Results(SEER)database for patients with chondrosarcoma aged>60 years diagnosed between 2004 and 2015.A total of 705 patients with chondrosarcoma aged>60 years were included in the SSER database.The data were divided into a training set and an internal validation set according to a ratio of 7:3.The training set data were screened for meaningful variables using Kaplan-Meier survival curve analysis,and then included in multifactorial cox regression analyses to screen for independent risk factors affecting healing.Column line graphs were created for the screened independent risk factors.In addition,data from 68 patients with chondrosarcoma aged>60 years diagnosed in Xinjiang Medical University Hospital from 2012 to 2021 were collected as the external validation set.The results were evaluated by C-index,receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)in the training set,internal validation set and external validation set.Results Independent risk factors affecting prognosis in chondrosarcoma patients over 60 years of age included age(HR:2.452,95%CI:1.826-3.293),tumour size(HR:1.498,95%CI:1.162-1.931),tumour number(HR:0.704,95%CI:0.542-0.916),histological type(HR:1.151,95%CI:1.065-1.243),grade(HR:1.447,95%CI:1.246-1.681),N-stage(HR:3.930,95%CI:1.690-9.141),M-stage(HR:2.297,95%CI:1.519-3.473)and surgery(HR:0.345,95%CI:0.233-0.511).The C-index of the training set,internal validation set and external validation set were 0.763,0.723,0.766,and the area under the ROC curve for predicting 3-year survival was 0.842,0.765,and 0.809,respectively.The area under the ROC curve predicting 5-year survival was 0.822,0.757,and 0.812,respectively.The results of the calibration curves and DCA also confirmed that the establishment of the of the column-line graphs could accurately predict prognostic factors in elderly chondrosarcoma patients.Conclusions For patients with advanced chondrosarcoma,older age,larger and more tumours,undifferentiated tumours,high grade tumours,presence of lymph node metastasis,and distant metastasis produce poorer healing,and surgery is a protective factor for patients with advanced chondrosarcoma.
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