Construction and validation of nomograms for non‑metastatic Ewing sarcoma: A prognostic factor analysis based on the SEER database

ONCOLOGY LETTERS, 2021 · DOI: 10.3892/ol.2021.13038 · Published: January 1, 2021

Simple Explanation

Ewing sarcoma is a type of bone cancer that primarily affects children and adolescents. This study aimed to identify factors that can predict the prognosis of patients with non-metastatic Ewing sarcoma. The researchers used data from the SEER database to analyze a large group of patients. They identified several independent prognostic variables and developed nomograms to estimate overall survival (OS) and cause-specific survival (CSS). The nomograms were validated internally and externally. Results showed that age, sex, tumor extension, and surgery were independent prognostic factors for both OS and CSS.

Study Duration

9 Years (2005-2014) SEER database, 6 Years (2013-2018) external validation

Participants

627 patients with non-metastatic Ewing sarcoma from SEER database, 26 patients for external validation

Evidence Level

Not specified

Key Findings

1
Age, tumor extension, sex, International Classification of Diseases for Oncology, 3rd Edition histology, surgery and chemotherapy were identified as independent risk factors for OS and CSS.
2
The concordance indices (C‑indices) for internal validation of OS and CSS prediction were 0.791 and 0.813, which were higher than those for AJCC sixth edition (OS, 0.531; CSS, 0.534) and seventh edition (OS, 0.547; CSS, 0.561).
3
The concordances of external validation based on the cohort of The First Affiliated Hospital of Zhengzhou University (Zhengzhou, China) were 0.834 for OS and 0.825 for CSS.

Research Summary

The present study aimed to describe the clinical characteristics, and to construct and validate nomograms for patients with non‑metastatic Ewing sarcoma. Age, sex, tumor extension and surgery were independent prognostic factors for both OS and CSS. In addition, with regard to OS, the Ewing sarcoma subtype was a poor factor and chemotherapy was a favorable one. Nomograms based on reduced Cox models attained a satisfactory accuracy in predicting the survival of patients with non‑metastatic Ewing sarcoma and could assist clinicians in evaluating survival more accurately.

Practical Implications

Improved Prognosis Prediction

The nomograms can assist clinicians in making more accurate survival evaluations for patients with non-metastatic Ewing sarcoma.

Therapeutic Strategies

The identified prognostic factors can guide the development of appropriate therapeutic strategies for patients with non-metastatic Ewing sarcoma.

Personalized Treatment

The nomograms can contribute to personalized treatment approaches based on individual patient characteristics.

Study Limitations

1
Inaccurate variables appeared due to the criteria discrepancy in diagnosis and treatment methods that originated from different registries.
2
The retrospective nature of the present study was a limitation compared with a prospective study
3
The study lacked the detailed information for the chemotherapy and radiotherapy protocols used in the SEER database, including the treatment time, dose cycle, drug type and dosage

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