Abstract
Purpose
We developed a nomogram to predict 3-year, 5-year and 7-year cancer survival rates of cancer patients.
Methods
This prospective cohort study included 20,491 surviving patients first diagnosed with cancer in Guangzhou from 2010 to 2019. They were divided into a training and a validation group. Lifestyle, clinical and histological parameters (LCH) were included in multivariable Cox regression. Akaike information criterion was used to select prediction factors for the nomogram. The discrimination and calibration of models were assessed by concordance index (C-index), area under time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration plots. We used net reclassification index (NRI) and integrated discrimination improvement (IDI) to compare the clinical utility of LCH prediction model with the prediction model based on lifestyle factors (LF).
Results
13 prediction factors including age, sex, BMI, smoking status, physical activity, sleep duration, regular diet, tumor grading, TNM stage, multiple primary cancer and anatomical site were included in the LCH model. The LCH model showed satisfactory discrimination and calibration (C-index = 0.81 (95% CI 0.80–0.82) for training group and 0.80 (0.79–0.81) for validation group, both time-dependent AUC > 0.70). The LF model including smoking status, physical activity, sleep duration, regular diet, and BMI showed less satisfactory discrimination (C-index = 0.60 (95% CI 0.59–0.61) for training and 0.60 (0.58–0.62) for validation group). The LCH model had better accuracy and discriminative ability than the LF model, as indicated by positive NRI and IDI values.
Conclusions
The LCH model shows good accuracy, clinical utility and precise prognosis prediction, and may serve as a tool to predict cancer survival of cancer patients.
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Data availability
Due to ethical restrictions protecting patient privacy, data available on request from the Guangzhou Center for Disease Control and Prevention.
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Funding
This work was funded by the Special Foundation for Science and Technology Basic Research Program (2019FY101103) and Natural Science Foundation of China (No. 81941019).
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CS, LX, SXW and HX contributed to the design of study, conducted study, and drafted the initial manuscript. LX and BHL contributed to the idea and design of this study, and revised manuscript. CS and KL assisted in analyzing data and interpreting the data. All authors read and approved the final manuscript.
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This study has been approved by the Guangzhou Municipal Health Commission. Ethical approval of this study was obtained from the ethical committee in the Guangzhou Center for Disease Control and Prevention.
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Sun, C., Xu, H., Wang, S. et al. Lifestyle, clinical and histological indices-based prediction models for survival in cancer patients: a city-wide prospective cohort study in China. J Cancer Res Clin Oncol 149, 9965–9978 (2023). https://doi.org/10.1007/s00432-023-04888-8
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DOI: https://doi.org/10.1007/s00432-023-04888-8