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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1417226
Individualized Evaluation of Risk and Prognosis in Uterine Leiomyosarcoma Patients with Synchronous Distant Metastases: A Real-world Retrospective Study
Provisionally accepted- 1 Mianyang Central Hospital, Mianyang, Sichuan Province, China
- 2 West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
Background The objective of this study was to determine independent risk variables related to distant metastases in patients with uLMS and prognostic factors for those with distant metastases Subsequently to practical nomograms were developed and validated to assess the probability of distant metastases and predict survival outcomes for these with distant metastases. Methods A real-world retrospective study was carried out using data from patients diagnosed with primary uLMSs in the SEER database spanning the years 2010 to 2015. Univariate and multivariate logistic regression analyses were utilized to identify clinicopathological characteristics related to the risk of distant metastases, while univariate and multivariate Cox regressions were employed to determine prognostic factors. A risk nomogram incorporating independent risk variables and a prognostic nomogram integrating independent prognostic factors were established in the training cohort and validated for accuracy in the validation cohort, respectively. ROC curves, AUC, and calibration curves were utilized to measure the accuracy of nomograms, while DCA curves were employed to assess their clinical benefit capacity. Based on the median total point derived from the prognostic nomogram, patients were stratified into high- and low-risk groups. Results: The study encompassed 1,362 patients diagnosed with uLMS, among whom 337 cases (24.7%) manifested synchronous distant metastases at the initial diagnosis. Univariate and multivariate logistic regression analyses identified race, histological grade, T stage, N stage, tumor size, surgery, and chemotherapy as independent risk factors for distant metastases in uLMS patients. The outcomes of both univariate and multivariate Cox analyses indicated that surgery and chemotherapy emerged as independent protective factors for prognosis in uLMS patients with distant metastases, whereas higher histological grade and T stage were identified as independent risk factors. The risk nomogram incorporating independent risk variables and the prognostic nomogram integrating independent prognostic factors could respectively predict the risk of metastases and the prognosis very effectively in both training and validation cohorts. Conclusions In summary, we developed the novel well-validated risk nomogram to precisely assess the probability of metastases in uLMS patients and prognostic nomogram to predict the prognosis of those with distant metastases, providing decision-making guidance for tailoring individualized clinical management of these patients.
Keywords: Uterine leiomyosarcoma, nomogram, Distant metastases, Risk factors, prognosis
Received: 23 Apr 2024; Accepted: 26 Aug 2024.
Copyright: © 2024 Liu, Gao, Min, Shang, Wang and Pu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhongli Liu, Mianyang Central Hospital, Mianyang, 621000, Sichuan Province, China
Tao Min, Mianyang Central Hospital, Mianyang, 621000, Sichuan Province, China
Qianqian Shang, Mianyang Central Hospital, Mianyang, 621000, Sichuan Province, China
Bin Wang, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
Jing Pu, Mianyang Central Hospital, Mianyang, 621000, Sichuan Province, China
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