International Journal of Clinical Oncology

, Volume 24, Issue 11, pp 1459–1467 | Cite as

Development and validation of a nomogram containing the prognostic determinants of chondrosarcoma based on the Surveillance, Epidemiology, and End Results database

  • Jun Zhang
  • Zhenyu Pan
  • Fanfan Zhao
  • Xiaojie Feng
  • Yuanchi Huang
  • Chuanyu Hu
  • Yuanjie LiEmail author
  • Jun LyuEmail author
Original Article



We aimed to develop and validate a reliable nomogram for predicting the disease-specific survival (DSS) of chondrosarcoma patients.


The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2004 to 2015 to identify cases of histologically confirmed chondrosarcoma. Multivariate Cox regression analysis was performed to identify independent prognostic factors and construct a nomogram for predicting the 3- and 5-year DSS rates. Predictive values were compared between the new model and the American Joint Committee on Cancer (AJCC) staging system using concordance indexes (C-indexes), calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA).


Multivariate Cox regression identified 1180 patients, who were used to establish a nomogram based on a new model containing the predictive variables of age, socioeconomic status, tumor size, surgery status, chemotherapy status, and AJCC staging. In the nomogram, age at diagnosis is the factor with the highest risk, followed by AJCC stage IV and tumor size > 100 mm. Both the C-index and the calibration plots demonstrated the good performance of the nomogram. Moreover, both NRI and IDI were improved compared to the AJCC staging system, and also DCA demonstrated that the nomogram is clinically useful.


We have developed a reliable nomogram for determining the prognosis and treatment outcomes of chondrosarcoma patients that is superior to the traditional AJCC staging system.


Nomogram Chondrosarcoma Survival SEER 



This study was funded by National Social Science Foundation of China (No. 16BGL183), and the Research Fund of Health Bureau of Xi’an (No. QFO1330).

Compliance with ethical standards

Conflict of interest

No financial interests are to be disclosed by the authors.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Clinical Research CenterThe First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina
  2. 2.School of Public HealthXi’an Jiaotong University Health Science CenterXi’anChina
  3. 3.Department of OrthopaedicsBaoji Municipal Central HospitalBaojiChina
  4. 4.Department of PharmacyThe Affiliated Children Hospital of Xi’an Jiaotong UniversityXi’anChina
  5. 5.Center of Stomatology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  6. 6.Department of Human Anatomy, Histology and Embryology, School of Basic Medical SciencesXi’an Jiaotong University Health Science CenterXi’anChina
  7. 7.Institute of Evidence-Based Medicine and Knowledge TranslationHenan UniversityKaifengChina

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