Survival of patients and risk factors for subependymoma: a population-based study

ABSTRACT

Objective

Given the paucity of data on the subependymoma, we aimed to evaluate its risk factors from the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

We collected survival and clinical information on patients with subependymoma diagnosed between 1975 and 2016 from the SEER database and screened them according to inclusion and exclusion criteria. Then, univariate and multivariate Cox regression analyses were used to identify significant prognostic factors, and nomograms were constructed to visualize the results. The concordance index (C-index), receiver operating characteristic (ROC), and calibration curves were used to assess the predictive ability of the nomogram. We divided the patient scores into two groups according to the high- and low-risk groups and constructed a survival curve using Kaplan–Meier analysis.

Results

A total of 731 patients were initially enrolled, including 511 (69.9%) males and 220 (30.1%) females. After screening, a total of 581 patientswere further evaluated by statistical analysis. The 5- and 10-year survival estimates were 92.0% and 81.9%, respectively. Sex (male, p=0.018; HR=2.3547, 95% CI=1.158-4.788) and age (≥56 years, p<0.001; HR=5.640, 95% CI= 3.139-10.133) were identified as independent prognostic factors for overall survival. The nomogram contained 4 prognostic factors. The C-index was 0.741, and the ROC and calibration curves also indicated the good predictability of the nomogram.

Conclusion

In this large cohort, a significant association was noted between age/sex and outcome, which could serve an important role for patient education. Even though a significant association was not found between the extent of resection and outcome, the effect of surgery on prognosis should be further explored.

Abbreviations: AUC: area under the curve; CI: confidence interval; C-index: concordance index; CNS: central nervous system; GTR: gross total resection; HR: hazard ratio; NOS: not specific; OS: overall survival; PTR: partial resection; ROC: receiver operating characteristic; SEER: Surveillance, Epidemiology, and End Results; STR: subtotal resection; WHO: World Health Organization

KEYWORDS:

• Risk factors
• Subependymoma
• SEER database

Authorship

Conception and experimental design: Gui-Jun Zhang & Chao You.

Acquisition of data: Gui-Jun Zhang & Xu Cheng

Analysis and interpretation of data: Gui-Jun Zhang & Xu Cheng.

Drafting the article: Gui-Jun Zhang

Critically revising the article: Gui-Jun Zhang & Chao You.

Reviewed the submitted version of manuscript: Gui-Jun Zhang & Xu Cheng.

Statistical analysis: Gui-Jun Zhang

Approved the final version of the manuscript on behalf of all authors: Chao You. Administrative/technical/material support: Gui-Jun Zhang & Chao You.

Study supervision: Gui-Jun Zhang & Chao You.

Availability of data and material statement

No publicly available datasets in this study

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This study was approved by the Institutional Review Board.

Informed consent

The informed consent was available for all patients and publication.

Additional information

Funding

Supported by 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (NO. 2018HXFH010).

Notes on contributors

Gui-Jun Zhang

Gui-Jun Zhang studies in the department of Neurosurgery, West China Hospital, Sichuan University.

Xu Cheng

Xu Cheng works in the department of Anesthesiology, West China Hospital, Sichuan University.

Cong Chen

Cong Chen works in the department of Neurosurgery, Tianjin Fifth Central Hospital.

Chao You

Chao You works in the department of Neurosurgery, West China Hospital, Sichuan University.