Abstract
Purpose
This study aimed to assess the cumulative incidences of Non-melanoma skin cancer (NMSC)-specific mortality (NMSC-SM) and develop a competing risk nomogram for NMSC-SM.
Methods
Data on patients diagnosed with NMSC between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. To identify the independent prognostic factors, univariate and multivariate competing risk models were used, and a competing risk model was constructed. Based on the model, we developed a competing risk nomogram to predict the 1-, 3-, 5-, and 8-year cumulative probabilities of NMSC-SM. The precision and ability to discriminate of the nomogram were evaluated through the utilization of metrics, such as receiver-operating characteristic (ROC) area under the curve (AUC), concordance index (C-index), and a calibration curve. Decision curve analysis (DCA) was employed to assess the clinical usefulness of the nomogram.
Results
Race, age, the primary site of the tumor, tumor grade, size, histological type, summary stage, stage group, order of radiation and surgery, and bone metastases were identified as independent risk factors. The prediction nomogram was constructed using the variables mentioned above. The ROC curves implied the good discrimination ability of the predictive model. The nomogram's C-index was 0.840 and 0.843 in the training and validation sets, respectively, and the calibration plots were well fitted. In addition, the competing risk nomogram demonstrated good clinical usefulness.
Conclusion
The competing risk nomogram displayed excellent discrimination and calibration for predicting NMSC-SM, which can be used in clinical contexts to help guide treatment decisions.
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Data availability
Data supporting the findings of this study are publicly available at the National Cancer Database and Surveillance, Epidemiology and End Results Program.
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This work was supported by grants from the National Science & Technology Fundamental Resources Investigation Program of China to L.Z. (No. 2018FY100900), the Hunan Provincial Natural Science Foundation of China Grant to Y.Z. (No. 2021JJ30923), the Provincial Science and Technology Innovation Leading Talents Project to L.Z. (No. 2021RC4014) and the Changsha Municipal Natural Science Foundation of China Grant to L.T. (No. kq2202022). The fund was not involved in any study design, data collection, analysis and interpretation, report writing, and article submission for publication.
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LT wrote the manuscript. YL, YZ, and LZ analyzed the data, YL and YZ provided professional comments to the manuscript. All authors have read and approved the final manuscript.
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Tang, L., Zhang, L., Zeng, Y. et al. Competing risk nomogram for predicting cancer-specific mortality in patients with non-melanoma skin cancer. J Cancer Res Clin Oncol 149, 8817–8827 (2023). https://doi.org/10.1007/s00432-023-04826-8
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DOI: https://doi.org/10.1007/s00432-023-04826-8