J Cancer 2019; 10(21):5299-5305. doi:10.7150/jca.32741

Research Paper

Development and validation of a nomogram for predicting cancer-specific survival in patients with Wilms' tumor

Zhenyu Pan1,2,3,*, Haisheng You4,*, Qingting Bu5, Xiaojie Feng1,2, Fanfan Zhao1,2, Yuanjie Li6, Jun Lyu1,2✉

1. Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
2. School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
3. Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
4. Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
5. Department of Genetics, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
6. Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
*These authors contributed equally to the article.

Abstract

Purpose: The objective of this study was to develop and validate a nomogram for predicting the cancer-specific survival (CSS) in patients with Wilms' tumor (WT).

Methods: Patients with WT diagnosed between 2002 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were divided randomly into training and validation cohorts in this study. Multivariate Cox regression analysis was used to screen variables. A Cox proportional-hazards regression model and a nomogram were constructed based on variables that significantly affected the CSS in the training cohort. The nomogram for distinguishing and predicting the CSS was evaluated using the concordance index (C-index), the area under the time-dependent receiver operating characteristic curve (AUC), and calibration plots.

Results: In total, 1631 patients from the SEER database were enrolled, with 1141 categorized into the training cohort and 490 into the validation cohort. All significant variables associated with CSS—age, the number of examined lymph nodes, SEER stage, and tumor size—were included in the nomogram. The C-index values of the nomogram in the training and validation cohorts were 0.746 and 0.703, respectively. The 3-, 5-, and 10-year AUCs were 0.755, 0.749, and 0.724, respectively, in the training cohort, and 0.718, 0.707, and 0.718 in the validation cohort. The calibration plots indicated the nomogram could accurately predict the 3-, 5-, and 10-year CSS.

Conclusions: We have developed and validated the first nomogram for predicting the survival of WT patients. The nomogram is a reliable tool for distinguishing and predicting the CSS in patients with WT. Information provided by the nomogram may help to improve the clinical practices related to WT.

Keywords: Wilms' tumor, nomogram, predict, survival

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How to cite this article:
Pan Z, You H, Bu Q, Feng X, Zhao F, Li Y, Lyu J. Development and validation of a nomogram for predicting cancer-specific survival in patients with Wilms' tumor. J Cancer 2019; 10(21):5299-5305. doi:10.7150/jca.32741. Available from http://www.jcancer.org/v10p5299.htm