Abstract
Background: The aim of this study was to construct and validate
a nomogram and risk stratification model for predicting cancer-specific
survival (CSS) of pediatric brainstem glioma patients.
Methods: Cases of pediatric brainstem glioma patients
(<12 years) from 1998 to 2016 were retrieved from the
Surveillance, Epidemiology, and End Results (SEER) database and
demographic, clinicopathologic characteristics, treatments, and survival
outcomes were analyzed. The total cohort was randomly divided into
training and validation sets, followed by univariate and multivariate
Cox regression analyses. A nomogram was constructed and risk
stratification analysis incorporated using the selected variables from
the multivariate analysis. The accuracy of the model was assessed using
C-index and calibration curves.
Results: A total of 806 pediatric cases with histologically
confirmed diagnosis of brainstem glioma were selected and analyzed.
Multivariate analysis showed that
age,
race, tumor size, grade and radiotherapy (P<0.05) were
independent prognostic indicators of pediatric gliomas. For prediction
of CSS, the C-index of the nomogram was 0.75, which shows a good
predictive probability.
Conclusion: The nomogram developed in this study for predicting
survival of pediatric patients with histologically confirmed stem
gliomas is the first to incorporate risk stratification. Combining
nomogram and risk stratification system is a convenient tool to aid
clinicians in the identification of high-risk patients and to perform
targeted adjuvant treatment.
Keywords: Glioma, Nomogram, Prognosis, Brainstem, SEER