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Development and validation of prognostic nomograms in patients with adrenocortical carcinoma: a population-based study

  • Urology - Original Paper
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Abstract

Background

Predicting the prognosis of patients with adrenocortical carcinoma (ACC) is difficult, due to its unpredictable behavior. The aim of this study is to develop and validate a nomogram to predict survival outcomes in patients with ACC.

Methods

Nomograms were established using the data collected from the Surveillance, Epidemiology, and End Results (SEER) database. Based on univariate and multivariate Cox regression analyses, we identified independent risk factors for overall survival (OS) and cancer-specific survival (CSS). Concordance indexes (c-indexes), the area under the receiver operating characteristics curve (AUC) and calibration curve were used to evaluate predictive performance of these models. The clinical use of nomogram was measured by decision curve analysis (DCA) and clinical impact curves.

Results

A total of 855 eligible patients, randomly divided into training (n = 600) and validation cohorts (n = 255), were included in this study. Based on the independent predictors, the nomograms were established and demonstrated good discriminative abilities, with C-indexes for OS and CSS were 0.762 and 0.765 in training cohorts and 0.738 and 0.758 in validation cohorts, respectively. The AUC and calibration plots also demonstrated a good performance for both nomograms. DCA indicated that the two nomograms provide clinical net benefits.

Conclusion

We unveiled the prognostic factors of ACC and developed novel nomograms that predict OS and CSS more accurately and comprehensively, which can help clinicians improve individual treatment, making proper clinical decisions and adjusting follow-up management strategies.

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Acknowledgements

We thank the seer database and the data gatherers in every registries.

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Authors and Affiliations

  1. Department of Urology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52, Meihua East Road, Zhuhai, 519000, Guangdong, China

    Hao Zhang, Yaser Naji, Minbo Yan, Wenfei Lian, Maochun Xie & Yingbo Dai

  2. Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, Guangdong, China

    Hao Zhang & Yingbo Dai

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  1. Hao Zhang
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  2. Yaser Naji
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Correspondence to Yingbo Dai.

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Zhang, H., Naji, Y., Yan, M. et al. Development and validation of prognostic nomograms in patients with adrenocortical carcinoma: a population-based study. Int Urol Nephrol 52, 1057–1071 (2020). https://doi.org/10.1007/s11255-020-02413-1

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