Nomograms for predicting long-term overall survival and cancer-specific survival in patients with primary urethral carcinoma: a population-based study
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Our aim was to identify the independent prognostic factors in patients with primary urethral carcinoma (PUC) and to predict their overall survival (OS) and cancer-specific survival (CSS) at 3, 5, and 8 years.
Patients with PUC identified in the Surveillance, Epidemiology, and End Results (SEER) database were divided into training and validation cohorts. Nomograms were constructed based on the results of Cox regression analysis. The predictive performance of each nomogram was evaluated using the consistency index (C-index), the area under the receiver operating characteristics curve (AUC), and calibration plots. Decision-curve analysis (DCA) was used to test the clinical value of the predictive models.
Our study screened 822 patients with PUC. Multivariate analysis showed that the age at diagnosis, race, histology, American Joint Committee on Cancer (AJCC) stage, and surgery status were independent prognostic factors for CSS and age at diagnosis, race, histology, AJCC stage, surgery status, and chemotherapy for OS (all P < 0.05). We used these prognostic factors to construct nomograms. The C-indexes for OS and CSS were 0.713 and 0.741 in training cohorts and 0.714 and 0.738 in validation cohorts, respectively. The AUC and calibration plots demonstrated the good performance of both nomograms. The DCA indicated the presence of clinical net benefits in both the training and validation cohorts.
We developed and validated nomograms for predicting OS and CSS in patients with PUC, which can help clinicians make treatment decisions.
KeywordsPrimary urethral carcinoma Overall survival Cancer-specific survival Nomogram SEER
Primary urethral carcinoma
American Joint Committee on Cancer
Surveillance, Epidemiology, and End Results
The third revision of International Classification of Disease for Oncology
Transitional cell carcinoma
Squamous cell carcinoma
Area under the receiver operating characteristics curve
HZ and XDL were responsible for conception, design, and quality control of this study. LG, ZHY, and CYW conducted data management, analysis, and interpretation. HZ and JL participated in statistical analyses. HZ, LG, ZHY, and CYW contributed to manuscript drafting and editing. XQR and XDL reviewed the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
Since all of the information in the SEER database has been de-identified, no institutional review board approval or informed consent was required for this study.
Consent for publication
All authors listed approved the publication of the manuscript.
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