这项研究代表了免疫检查点抑制剂时代为转移性软组织肉瘤 (mSTS) 患者开发预测生存列线图的首次努力。从监测、流行病学和最终结果 (SEER) 计划数据库中，我们提取了 3078 名符合条件的 mSTS 患者2016 年至 2022 年间。进行了 Kaplan-Meier 生存分析、单变量和多变量 Cox 分析以及单变量和多变量逻辑分析。随后，构建了预测列线图。使用曲线下面积（AUC）、校准曲线和决策曲线分析（DCA）方法验证临床有效性。我们使用 SEER 数据库纳入 2016 年至 2022 年间 3078 名符合条件的 mSTS 患者。所有符合条件的患者均随机分配按 6:4 的比例分为训练组 (n = 1846) 和验证组 (n = 1232)。在多变量Cox分析中，年龄、种族、婚姻状况、病理分级、组织学亚型、手术和化疗被确定为独立的预后因素。这些因素用于构建列线图来预测 mSTS 患者的 1 年、3 年和 5 年 OS。训练队列和验证队列的 C 指数分别为 0.722（95% 置信区间 [CI]：0.708-0.736）和 0.716（95% CI：0.698-0.734）。 1 年、3 年和 5 年 OS 概率的校准曲线显示了预测生存率和实际生存率之间的出色校准。训练队列中 1 年、3 年和 5 年列线图的 AUC 值分别为 0.785、0.767 和 0.757，验证队列中分别为 0.773、0.754 和 0.751。此外，DCA 表明列线图在两个队列中都具有良好的临床效用。利用已建立的列线图构建风险分层系统，提高了预测准确性，帮助临床医生识别高危患者并为治疗决策提供依据。本研究标志着免疫检查点抑制剂时代首次构建mSTS患者预测生存列线图。稳健构建的列线图以及实际结果为后续管理策略提供了宝贵的见解。版权所有 © 2024 Han、Li、Xu、Hu、Chen 和 Wang。

This study represented the inaugural effort to develop predictive survival nomograms for metastatic soft tissue sarcoma (mSTS) patients in the era of immune checkpoint inhibitors.From the Surveillance, Epidemiology, and End Results (SEER) program database, we extracted 3078 eligible patients with mSTS between 2016 and 2022. Kaplan-Meier survival analysis, univariate and multivariable Cox analyses, and univariate and multivariable logistic analyses were conducted. Subsequently, predictive nomograms were constructed. Clinical effectiveness was validated using the area under the curve (AUC), calibration curve, and decision curve analysis (DCA) methods.We used the SEER database to include 3078 eligible patients with mSTS between 2016 and 2022. All the eligible patients were randomly allocated in a ratio of 6:4 and stratified into a training group (n = 1846) and a validation group (n = 1232). In the multivariate Cox analysis, age, race, marital status, pathological grade, histologic subtype, surgery, and chemotherapy were identified as independent prognostic factors. These factors were used to construct the nomogram to predict the 1-, 3-, and 5-year OS of mSTS patients. The C-index for the training cohort and the validation cohort was 0.722(95% confidence interval [CI]: 0.708-0.736), and 0.716(95% CI: 0.698-0.734), respectively. The calibration curves for 1-, 3-, and 5-year OS probability demonstrated excellent calibration between the predicted and the actual survival. The AUC values of the nomogram at 1-, 3-, and 5-year were 0.785, 0.767, and 0.757 in the training cohort, 0.773, 0.754, and 0.751 in the validation cohort, respectively. Furthermore, DCA indicated the favorable clinical utility of the nomogram in both cohorts. The risk stratification system was constructed using the established nomogram, which enhanced prediction accuracy, aided clinicians in identifying high-risk patients and informing treatment decisions.This study marked the inaugural effort in constructing predictive survival nomograms mSTS patients in the era of immune checkpoint inhibitors. The robustly constructed nomograms, alongside actual outcomes, offered valuable insights to inform follow-up management strategies.Copyright © 2024 Han, Li, Xu, Hu, Chen and Wang.