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( Junyi Shen ),( Linye He ),( Chuan Li ),( Tianfu Wen ),( Weixia Chen ),( Changli Lu ),( Lvnan Yan ),( Bo Li ),( Jiayin Yang ) 대한간학회 2017 Gut and Liver Vol.11 No.5
Background/Aims: Solitary hepatocellular carcinoma (HCC) is a subgroup of HCCs. We aimed to establish nomograms for predicting the survival of solitary HCC patients after hepatectomy. Methods: A total of 538 solitary HCC patients were randomly classified into training and validation sets. A Cox model was used to identify predictors of overall survival (OS) in the training set. A nomogram was generated based on these predictors and was validated using the validation set. Results: Tumor size, microvascular invasion, and major vascular invasion were significantly associated with OS in the training set. Nomograms were developed based on these predictors in the multivariate analysis. The C-index was 0.75 for the OS nomogram and 0.72 for the recurrence-free sur-vival nomogram. Compared to the index of conventional stag-ing systems for predicting survival (0.71 for Barcelona Clinic Liver Cancer, 0.66 for the seventh American Joint Committee on Cancer, 0.68 for Cancer of the Liver Italian Program, and 0.70 for Hong Kong Liver Cancer), the index of the OS nomo-gram was significantly higher. Moreover, the calibration curve fitted well between the predicted and observed survival rate. Similarly, in the validation set, the nomogram discrimination was superior to those of the four staging systems (p<0.001). Conclusions: The nomograms demonstrated good discrimi-nation performance in predicting 3- and 5-year survival rates for solitary HCCs after hepatectomy. (Gut Liver 2017;11:684- 692)
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김평수,이경묵,한동석,유문원,한혜승,양한광,방호윤 대한위암학회 2017 Journal of gastric cancer Vol.17 No.3
Purpose: Recently, a nomogram predicting overall survival after gastric resection was developed and externally validated in Korea and Japan. However, this gastric cancer nomogram is derived from large-volume centers, and the applicability of the nomogram in smaller centers must be proven. The purpose of this study is to externally validate the gastric cancer nomogram using a dataset from a medium-volume center in Korea. Materials and Methods: We retrospectively analyzed 610 patients who underwent radical gastrectomy for gastric cancer from August 1, 2005 to December 31, 2011. Age, sex, number of metastatic lymph nodes (LNs), number of examined LNs, depth of invasion, and location of the tumor were investigated as variables for validation of the nomogram. Both discrimination and calibration of the nomogram were evaluated. Results: The discrimination was evaluated using Harrell's C-index. The Harrell's C-index was 0.83 and the discrimination of the gastric cancer nomogram was appropriate. Regarding calibration, the 95% confidence interval of predicted survival appeared to be on the ideal reference line except in the poorest survival group. However, we observed a tendency for actual survival to be constantly higher than predicted survival in this cohort. Conclusions: Although the discrimination power was good, actual survival was slightly higher than that predicted by the nomogram. This phenomenon might be explained by elongated life span in the recent patient cohort due to advances in adjuvant chemotherapy and improved nutritional status. Future gastric cancer nomograms should consider elongated life span with the passage of time.
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서원익,최성협,정재일 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.12
Purpose: No standard number of cores is obtained with a prostate needle biopsy. Routinely, we obtain 10 core biopsies but do not consider prostate volume or patient age. Consequently, we evaluated the clinical efficacy of prostate biopsy when taking into account prostate volume and patient age by use of the Vienna nomogram to suggest the proper number of cores. Materials and Methods: Transrectal ultrasonography (TRUS)-guided prostate needle biopsies were performed in 326 patients between November 2006 and June 2009. Group A (10 cores biopsy) was 131 patients. Group B (biopsy using Vienna nomogram) was 134 patients. We compared the cancer detection rate between the two groups, especially according to age and prostate volume. The chi-squared test was used for statistical analysis. Results: The overall cancer detection rates in groups A and B were 33.6% and 32.1%, respectively. In older patients (age≥60 years), group B had a higher detection rate than did group A (37.0% vs. 35.6%). For patients with a small prostate (<30 g), group B had a significantly higher detection rate than did group A (62.1% vs. 30.4%, p=0.023). Conclusions: There was no significant difference in the overall cancer detection rate. However, in patients with a small prostate and in older patients, the Vienna nomogram was more effective than a 10-core biopsy. The Vienna nomogram could help to establish guidelines for prostate biopsy in Korea that take into account the prostate volume and the age of the patient. It could also help urologists to reduce unnecessary cores when diagnosing prostate cancer in the elderly population and in those with small prostates. Purpose: No standard number of cores is obtained with a prostate needle biopsy. Routinely, we obtain 10 core biopsies but do not consider prostate volume or patient age. Consequently, we evaluated the clinical efficacy of prostate biopsy when taking into account prostate volume and patient age by use of the Vienna nomogram to suggest the proper number of cores. Materials and Methods: Transrectal ultrasonography (TRUS)-guided prostate needle biopsies were performed in 326 patients between November 2006 and June 2009. Group A (10 cores biopsy) was 131 patients. Group B (biopsy using Vienna nomogram) was 134 patients. We compared the cancer detection rate between the two groups, especially according to age and prostate volume. The chi-squared test was used for statistical analysis. Results: The overall cancer detection rates in groups A and B were 33.6% and 32.1%, respectively. In older patients (age≥60 years), group B had a higher detection rate than did group A (37.0% vs. 35.6%). For patients with a small prostate (<30 g), group B had a significantly higher detection rate than did group A (62.1% vs. 30.4%, p=0.023). Conclusions: There was no significant difference in the overall cancer detection rate. However, in patients with a small prostate and in older patients, the Vienna nomogram was more effective than a 10-core biopsy. The Vienna nomogram could help to establish guidelines for prostate biopsy in Korea that take into account the prostate volume and the age of the patient. It could also help urologists to reduce unnecessary cores when diagnosing prostate cancer in the elderly population and in those with small prostates.
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Kim, Pyeong Su,Lee, Kyung-Muk,Han, Dong-Seok,Yoo, Moon-Won,Han, Hye Seung,Yang, Han-Kwang,Bang, Ho Yoon The Korean Gastric Cancer Association 2017 Journal of gastric cancer Vol.17 No.3
Purpose: Recently, a nomogram predicting overall survival after gastric resection was developed and externally validated in Korea and Japan. However, this gastric cancer nomogram is derived from large-volume centers, and the applicability of the nomogram in smaller centers must be proven. The purpose of this study is to externally validate the gastric cancer nomogram using a dataset from a medium-volume center in Korea. Materials and Methods: We retrospectively analyzed 610 patients who underwent radical gastrectomy for gastric cancer from August 1, 2005 to December 31, 2011. Age, sex, number of metastatic lymph nodes (LNs), number of examined LNs, depth of invasion, and location of the tumor were investigated as variables for validation of the nomogram. Both discrimination and calibration of the nomogram were evaluated. Results: The discrimination was evaluated using Harrell's C-index. The Harrell's C-index was 0.83 and the discrimination of the gastric cancer nomogram was appropriate. Regarding calibration, the 95% confidence interval of predicted survival appeared to be on the ideal reference line except in the poorest survival group. However, we observed a tendency for actual survival to be constantly higher than predicted survival in this cohort. Conclusions: Although the discrimination power was good, actual survival was slightly higher than that predicted by the nomogram. This phenomenon might be explained by elongated life span in the recent patient cohort due to advances in adjuvant chemotherapy and improved nutritional status. Future gastric cancer nomograms should consider elongated life span with the passage of time.
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Ji-Jin Yao,Li Lin,Tian-Sheng Gao,Wang-Jian Zhang,Wayne R. Lawrence,Jun Ma,Ying Sun 대한암학회 2021 Cancer Research and Treatment Vol.53 No.3
Purpose This study aimed to develop web-based nomograms to precisely predict survival outcomes in patients with non-metastatic nasopharyngeal carcinoma (NPC) in an endemic area. Materials and Methods A total of 10,126 patients who underwent radical intensity-modulated radiotherapy at Sun Yat-sen University Cancer Center (SYSUCC) from 2009 to 2015 were analyzed. We assigned patients into a training cohort (SYSUCC-A, n=6,751) and an internal validation cohort (SYSUCC-B, n=3,375) based on computer-generated random numbers. Patients collected from Wuzhou Red Cross Hospital (WZRCH) between 2012 and 2015 were used as the independent external validation cohort (WZRCH, n=450). Concordance index (C-index) was used to determine predictive accuracy and discriminative ability for the nomogram. The web-based clinicopathologic prediction models for predicting survival were based on Cox regression. Results The C-indexes for SYSUCC-A, SYSUCC-B, and WZRCH cohorts for the established nomograms to predict 3-year overall survival (OS) was 0.736, 0.715, and 0.691. Additionally, C-indexes to predict 3-year distant metastasis-free survival (DMFS) was 0.717, 0.706, and 0.686, disease-free survival (DFS) was 0.713, 0.697, and 0.656, local relapse-free survival was 0.695, 0.684, and 0.652, and regional relapse-free survival was 0.672, 0.650, and 0.616. The calibration plots showed great agreement between nomogram-predicted 3-year survival outcomes and actual 3-year survival outcomes. Moreover, C-indexes of the nomograms for OS, DMFS, and DFS were significantly superior than TNM stage (p < 0.001 for all). Conclusion These user-friendly nomograms can precisely predict survival endpoints in patients with non-metastatic NPC. They may serve as a useful tool for providing patient counseling and help physicians to make individual follow-up plans.
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Nomogram for predicting overall survival in children with neuroblastoma based on SEER database
Song-Wu Liang,Gang Chen,Yi-Ge Luo,Peng Chen,Jin-Han Gu,Qiong-Qian Xu,Yi-Wu Dang,Li-Ting Qin,Hui-Ping Lu,Wen-Ting Huang,Zhi-Guang Huang,Li Gao,Jia-Bo Chen 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.2
Purpose: This study was performed to establish and validate a nomogram for predicting the overall survival in children with neuroblastoma. Methods: The latest clinical data of neuroblastoma in Surveillance, Epidemiology, and End Results (SEER) database was extracted from 2000 to 2016. The cases included were randomly divided into training and validation cohorts. The survival curves were drawn with a Kaplan-Meier estimator to investigate the influences of certain single factors on overall survival. Also, least absolute shrinkage and selection operator regression was applied to further select the prognostic variables for neuroblastoma. Additionally, receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the accuracy of the nomogram. Results: In total, 1,262 patients were collected and 8 independent prognostic factors were achieved, including patients’ age, sex, race, tumor grade, radiotherapy, chemotherapy, tumor site, and tumor size. Then we constructed a nomogram by using the data of the training cohort with 886 cases. Subsequently, the nomogram was validated internally and externally with 886 and 376 cases, respectively. The internal validation revealed that the area under the curves (AUC) of ROC curves of 1-, 3-, and 5-year overall survival were 0.69, 0.78, and 0.81, respectively. Accordingly, the external validation also showed that the AUC of 1-, 3-, and 5-year overall survival were all ≥0.69. Both methods of validation demonstrated that the predictive calibration curves were consistent with standard curves. Conclusion: The nomogram possess the potential to be a new tool in predicting the survival rate of neuroblastoma patients.
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Claudia Marchetti,Francesca De Felice,Anna Di Pinto,Alessia Romito,Angela Musella,Innocenza Palaia,Marco Monti,Vincenzo Tombolini,Ludovico Muzii,PierLuigi Benedetti Panici 대한암학회 2018 Cancer Research and Treatment Vol.50 No.3
Purpose The purpose of this study was to develop nomograms for predicting the probability of overall survival (OS) and progression-free survival (PFS) in locally advanced cervical cancer treated with neoadjuvant chemotherapy and radical surgery. Materials and Methods Nomograms to predict the 5-year OS rates and the 2-year PFS rates were constructed. Calibration plots were constructed, and concordance indices were calculated. Evaluated variables were body mass index, age, tumor size, tumor histology, grading, lymphovascular space invasion, positive parametria, and positive lymph nodes. Results In total 245 patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy and radical surgery were included for the construction of the nomogram. The 5-year OS and PFS were 72.6% and 66%, respectively. Tumor size, grading, and parametria status affected the rate of OS, whereas tumor size and positive parametria were the main independent PFS prognostic factors. Conclusion We constructed a nomogram based on clinicopathological features in order to predict 2-year PFS and 5-year OS in locally advanced cervical cancer primarily treated with neoadjuvant chemotherapy followed by radical surgery. This tool might be particularly helpful for assisting in the follow-up of cervical cancer patients who have not undergone concurrent chemoradiotherapy.
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김나리,유정일,박희철,홍정용,임호영,고명지,백용한 대한간암학회 2023 대한간암학회지 Vol.23 No.2
Background/Aim: Patients with large (>5 cm) hepatocellular carcinoma (HCC) have limited treatment options, thus necessitating the identification of prognostic factors and the development of predictive tools. This study aimed to identify prognostic factors and to construct a nomogram to predict survival outcomes in patients with large HCC. Methods: A cohort of 438 patients, who were diagnosed with large HCC at a tertiary hospital between 2015 and 2018, was analyzed. Cox proportional hazards models were used to identify key prognosticators of overall survival (OS), and an independent set of prognostic factors was used to develop a nomogram. The discrimination and calibration abilities of the nomogram were assessed and internal validation was performed using cross-validation and bootstrapping methods. Results: During a median follow-up of 9.3 months, the median OS was 9.9 months, and the 1-year OS rate was 43.9%. Multivariable Cox regression analysis revealed that performance status, modified albumin-bilirubin grade, tumor size, extent of portal vein tumor thrombosis, and initial treatment significantly affected OS. The newly developed nomogram incorporating these variables demonstrated favorable accuracy (Harrell’s concordance index, 0.807). Conclusions: The newly developed nomogram facilitated the estimation of individual survival outcomes in patients with large HCC, providing an acceptable level of accuracy.
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( Baraem Yoo ),( Hyojeong Ahn ),( Miseon Kim ),( Dong Hoon Suh ),( Kidong Kim ),( Jae Hong No ),( Yong Beom Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.5
Objective The purpose of this study is to estimate the risk of postoperative lymphocele development after lymphadenectomy in gynecologic cancer patients through establishing a nomogram. Methods We retrospectively reviewed 371 consecutive gynecologic cancer patients undergoing lymphadenectomy between 2009 and 2014. Association of the development of postoperative lymphocele with clinical characteristics was evaluated in univariate and multivariate regression analyses. Nomograms were built based on the data of multivariate analysis using R-software. Results Mean age at the operation was 50.8±11.1 years. Postoperative lymphocele was found in 70 (18.9%) patients. Of them, 22 (31.4%) had complicated one. Multivariate analysis revealed that hypertension (hazard ratio [HR], 3.0; 95% confidence interval [CI], 1.5 to 6.0; P=0.003), open surgery (HR, 3.2; 95% CI, 1.4 to 7.1; P=0.004), retrieved lymph nodes (LNs) >21 (HR, 1.8; 95% CI, 1.0 to 3.3; P=0.042), and no use of intermittent pneumatic compression (HR, 2.7; 95% CI, 1.0 to 7.2; P=0.047) were independent risk factors for the development of postoperative lymphocele. The nomogram appeared to be accurate and predicted the lymphocele development better than chance (concordance index, 0.754). For complicated lymphoceles, most variables which have shown significant association with general lymphocele lost the statistical significance, except hypertension (P=0.011) and mean number of retrieved LNs (29.5 vs. 21.1; P=0.001). A nomogram for complicated lymphocele showed similar predictive accuracy (concordance index, 0.727). Conclusion We developed a nomogram to predict the risk of lymphocele in gynecologic cancer patients on the basis of readily obtained clinical variables. External validation of this nomogram in different group of patients is needed.
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Novel nomogram for screening the risk of developing diabetes in a Korean population
Chung, Seung Min,Park, Jae Cheol,Moon, Jun Sung,Lee, Jea Young Elsevier 2018 Diabetes research and clinical practice Vol.142 No.-
<P><B>Abstract</B></P> <P><B>Aims</B></P> <P>We propose a novel nomogram, which graphically expresses the numerical relationship between type 2 diabetes (T2D) and disease-related risk factors.</P> <P><B>Methods</B></P> <P>Data of 8999 patients from the 2013–2014 Korean National Health and Nutrition Examination Survey were analyzed. Multiple logistic regression analysis was performed to assess risk factors for T2D and a nomogram was constructed based on screened risk factors. A receiver operating curve (ROC) and calibration plot were created to evaluate the accuracy of the nomogram.</P> <P><B>Results</B></P> <P>The risk factor with the greatest impact on the prevalence of T2D was age over 60 years (95% CI 5.97–15.00, OR = 9.46), followed by presence of dyslipidemia and cardiovascular disease (95% CI 5.90–13.68, OR = 8.98), family history of T2D (95% CI 2.33–3.64, OR = 2.92), abdominal obesity (OR = 1.76), hypertension (OR = 1.75), male gender (OR = 1.55), current-smoking status (OR = 1.52), lower education level (OR = 1.42), and lower income (OR = 1.30). The area under the ROC curve (AUC) showed statistically significant determination (AUC = 0.83). The equation of the calibration plot was drawn along the ideal line; coefficient of determination was 0.864.</P> <P><B>Conclusion</B></P> <P>Our proposed nomogram could accurately predict the risk of T2D from nationwide data. The novel nomogram can be a useful tool for screening patients with T2D risk in a Korean population.</P>
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