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Risk factors for surgical compliance and impact on the survival of patients with glioma: a population-based propensity score-matched study

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Abstract

Purpose

To comprehensively analyze the impact of surgical compliance on the survival of patients with glioma and to explore the factors that influence surgical compliance.

Methods

Clinical data of patients with glioma between 2004 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier curves and Cox regression were used to analyze the effect of surgical compliance on overall survival (OS) and disease-specific survival (DSS). Multivariate Cox regression was used to select the prediction variables and construct the nomograms. The predictive power of these models was assessed using Harell’s consistency index (C-index), decision curve analysis (DCA), receiver operating characteristic (ROC) curves, and calibration curves. Multivariate logistic regression was performed to analyze the related variables of surgical compliance, and 1:1 propensity score matching (PSM) was applied to evaluate the validity of the results of patients with favorable and poor surgical compliance.

Results

Among the 47,573 eligible glioma patients recommended for surgery, 46,380 (97.5%) were in the surgical compliance group, while 1193 (2.5%) were in the noncompliance group. Surgical compliance was an independent prognostic factor for glioma patients, as indicated by multivariate Cox regression analysis that patients with surgical compliance had worse OS (hazard ratio [HR] 1.924; 95% confidence interval [CI] 1.800–2.056, p < 0.001) and DSS (HR 1.718; 95% CI 1.592–1.853, p < 0.001) in comparison to those without surgical compliance. A nomogram was developed and internally validated to be able to predict glioma prognosis. The nomogram can well predict patients’ OS (C-index: 0.745) and DSS (C-index: 0.744). ROC curve, DCA curve, and calibration curve were applied to further assess the accuracy of the nomogram. Poor surgical compliance was found to be related to older age, female gender, tumor diameter, grade II or higher, poor grading, tumor location in the cerebellum and brainstem, and low household income.

Conclusion

Surgical compliance is an independent prognostic factor for predicting the OS and DSS of patients with glioma, and good surgical compliance was significantly related to good survival.

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Data availability

The dataset for the current study is available from the corresponding author upon reasonable request.

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Acknowledgements

The authors are very grateful for the efforts of the SEER (Surveillance, Epidemiology, and End Results) Program tumor registry in creating the SEER database.

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Authors and Affiliations

  1. Emergency Department, Binhai County People’s Hospital, Yancheng, China

    Aifeng He & Leiming Xu

  2. Neurosurgery, Binhai County People’s Hospital, Yancheng, China

    Xudong Yang & Hai Zhou

  3. Oncology Department, Binhai County People’s Hospital, Yancheng, China

    Zhou Gu

  4. Department of Neurology, Binhai County People’s Hospital, Yancheng, China

    Yong Cai

Authors
  1. Aifeng He
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  2. Leiming Xu
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  3. Xudong Yang
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  4. Zhou Gu
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  6. Hai Zhou
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Contributions

AHE and AHZ: Conceptualization, methodology, software, writing-manuscript, writing-review, and editing. XY, YC and LX: software, visualization, data management and formal analysis. AHE and ZG: Writing, review, and editing. LX and XY: Conceptualization, supervision, project management, writing, review, and editing. HZ: Revision. All authors contributed to this article and approved the submitted version.

Corresponding author

Correspondence to Hai Zhou.

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The authors declare there are no potential conflicts of interest related to this study.

Ethical statement

This study used publicly available SEER cancer registry data rather than the human subject study.

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He, A., Xu, L., Yang, X. et al. Risk factors for surgical compliance and impact on the survival of patients with glioma: a population-based propensity score-matched study. J Cancer Res Clin Oncol 149, 14797–14815 (2023). https://doi.org/10.1007/s00432-023-05261-5

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  • DOI: https://doi.org/10.1007/s00432-023-05261-5

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