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Journal of Neurosurgical Sciences 2020 Sep 24

DOI: 10.23736/S0390-5616.20.05033-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Novel nomograms predicting overall and cancer-specific survival of malignant ependymoma patients: a population-based study

Mahmoud DIBAS 1, Sherief GHOZY 2, 3, Sara MORSY 4, Alzahraa SALAH ABBAS 5, Saad ALKAHTANI 6, May BIN-JUMAH 7, Mohamed M. ABDEL-DAIM 8, 9

1 Sulaiman Al Rajhi Colleges, College of Medicine, Al Bukairiyah, Saudi Arabia; 2 Mansoura University, Faculty of Medicine, Mansoura, Egypt; 3 Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt; 4 Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; 5 Faculty of Medicine, Minia University, Minia, Egypt; 6 Department of Zoology, Science College, King Saud University, Riyadh, Saudi Arabia; 7 Biology Department, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 8 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia; 9 Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia Egypt


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BACKGROUND: Malignant ependymomas are rare cancerous tumors that are associated with increased morbidity and mortality in the affected patients. Lately, there has been a lot of controversy about the correct way to manage and predict the survival outcome of these patients. We aim in this retrospective cohort study to develop novel nomograms that can better predict the overall survival (OS) and cancer-specific survival (CSS) of these patients.
METHODS: This is a retrospective cohort study that was conducted through the Surveillance, Epidemiology, and End Results databases (SEER) between 1998 and 2016. Patients were excluded if they had an unknown diagnosis, unknown cause of death or those with survival duration less than a month. We used penalized regression models with the highest timedependent area under the ROC curve (AUC) and most stable calibrations to construct the nomograms. By searching the SEER database and applying the eligibility criteria, we identified 3391 patients for the final analysis.
RESULTS: Nine penalized regression models were developed of which two models including adaptive elastic-net was selected for both OS and CSS. The model incorporated age, sex, year of diagnosis, site, race, radiation, chemotherapy, surgery, and type for the construction of nomograms. We aimed in this population-based cohort study to develop novel prediction tools that can help physicians estimate the survival of malignant ependymoma patients and provide better care.
CONCLUSIONS: Our nomograms appear to have high accuracy and applicability, which we hope that can predict the survival and improve the treatment and prognosis of these patients.


KEY WORDS: Ependymoma; Survival; SEER program; Nomograms; Brain neoplasms

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