Influencing factors for prognosis of primary tracheal malignancy and establishment of nomogram model for predicting its overall survival based upon SEER database_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAN Weijian ¹ , ZHAO Ye ² , FENG Haiming ¹ , WANG Cheng ¹ ,  LI Bin ¹

1. Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, 730030, P.R.China;
2. Department of Respiratory Medicine, Lanzhou University First Hospital, Lanzhou, 730000, P.R.China;

Corresponding author：

LI Bin, Email: dr.leebin@outlook.com

Keywords：

Primary tracheal malignancy; Surveillance, Epidemiology, and End Results (SEER); prediction model; nomogram

DOI：

10.7507/1007-4848.202010075

Video：

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Objective To analyze the factors affecting the prognosis of patients with primary tracheal malignancy, and establish a nomogram model for prediction its prognosis.Methods A total of 557 patients diagnosed with primary tracheal malignancy from 1975 to 2016 in the Surveillance, Epidemiology, and End Results Data were collected. The factors affecting the overall survival rate of primary tracheal malignancy were screened and modeled by univariate and multivariate Cox regression analysis. The nomogram prediction model was performed by R 3.6.2 software. Using the C-index, calibration curves and receiver operating characteristic (ROC) curve to evaluate the consistency and predictive ability of the nomogram prediction model.Results The median survival time of 557 patients with primary tracheal malignancy was 21 months, and overall survival rates of the 1-year, 3-year and 5-year were 59.1%±2.1%, 42.5%±2.1%, and 35.4%±2.2%. Univariate and multivariate Cox regression analysis showed that age, histology, surgery, radiotherapy, tumor size, tumor extension and the range of lymph node involvement were independent risk factors affecting the prognosis of patients with primary tracheal malignancy (P<0.05). Based on the above 7 risk factors to establish the nomogram prediction model, the C-index was 0.775 (95%CI 0.751-0.799). The calibration curve showed that the prediction model established in this study had a good agreement with the actual survival rate of the 1 year, 3 year and 5 years. The area under curve of 1-year, 3-year and 5-year predicting overall survival rates was 0.837, 0.827 and 0.836, which showed that the model had a high predictive power.Conclusion The nomogram prediction model established in this study has a good predictive ability, high discrimination and accuracy, and high clinical value. It is useful for the screening of high-risk groups and the formulation of personalized diagnosis and treatment plans, and can be used as an evaluation tool for prognostic monitoring of patients with primary tracheal malignancy.

Citation： YAN Weijian, ZHAO Ye, FENG Haiming, WANG Cheng, LI Bin. Influencing factors for prognosis of primary tracheal malignancy and establishment of nomogram model for predicting its overall survival based upon SEER database. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(5): 545-554. doi: 10.7507/1007-4848.202010075 Copy

1.	Nouraei SM, Middleton SE, Nouraei SA, et al. Management and prognosis of primary tracheal cancer: A national analysis. Laryngoscope, 2014, 124(1): 145-150.
2.	Majeed FA, Zafar U, Ali A, et al. Emergency tracheal surgery for adenoid cystic carcinoma: A rare entity. J Coll Physicians Surg Pak, 2018, 28(11): 882-884.
3.	Urdaneta AI, Yu JB, Wilson LD. Population based cancer registry analysis of primary tracheal carcinoma. Am J Clin Oncol, 2011, 34(1): 32-37.
4.	Baig MZ, Weber JF, Connery CP, et al. A SEER database cohort of 868 patients with primary tracheal cancers: Characteristics and outcomes and the role of bronchoscopic interventions. IJS Oncology, 2020, 5(4): 90.
5.	Wang HL, Xu L, Li FJ. Subglottic adenoid cystic carcinoma mistaken for asthma. J Zhejiang Univ Sci B, 2009, 10(9): 707-710.
6.	Bhattacharyya N. Contemporary staging and prognosis for primary tracheal malignancies: A population-based analysis. Otolaryngol Head Neck Surg, 2004, 131(5): 639-642.
7.	Scosyrev E, Messing J, Noyes K, et al. Surveillance Epidemiology and End Results (SEER) program and population-based research in urologic oncology: An overview. Urol Oncol, 2012, 30(2): 126-132.
8.	Simoni P, Peters GE, Magnuson JS, et al. Use of the endoscopic microdebrider in the management of airway obstruction from laryngotracheal carcinoma. Ann Otol Rhinol Laryngol, 2003, 112(1): 11-13.
9.	Shamji FM, Inculet R. Management of malignant tracheoesophageal fistula. Thorac Surg Clin, 2018, 28(3): 393-402.
10.	Moores D, Mane P. Pathology of primary tracheobronchial malignancies other than adenoid cystic carcinomas. Thorac Surg Clin, 2018, 28(2): 149-154.
11.	Honings J, Gaissert HA, Verhagen AF, et al. Undertreatment of tracheal carcinoma: Multidisciplinary audit of epidemiologic data. Ann Surg Oncol, 2009, 16(2): 246-253.
12.	Xie L, Fan M, Sheets NC, et al. The use of radiation therapy appears to improve outcome in patients with malignant primary tracheal tumors: A SEER-based analysis. Int J Radiat Oncol Biol Phys, 2012, 84(2): 464-470.
13.	Webb BD, Walsh GL, Roberts DB, et al. Primary tracheal malignant neoplasms: The University of Texas MD Anderson Cancer Center experience. J Am Coll Surg, 2006, 202(2): 237-246.
14.	Jeremic B, Shibamoto Y, Acimovic L, et al. Radiotherapy for primary squamous cell carcinoma of the trachea. Radiother Oncol, 1996, 41(2): 135-138.
15.	Chang CY, Cheng SL, Chang SC. Adenoid cystic carcinoma of trachea treated with tumor curettage and adjuvant intensity modulated radiation therapy. South Med J, 2011, 104(1): 68-70.
16.	Spinelli GP, Miele E, Prete AA, et al. Combined surgery and radiotherapy as curative treatment for tracheal adenoid cystic carcinoma: A case report. J Med Case Rep, 2019, 13(1): 52.
17.	王洪武, 程庆好, 孔令煜, 等. 大力倡导加速康复外科在气管恶性肿瘤介入治疗中的应用. 中国肺癌杂志, 2019, 22(1): 1-5.
18.	Levin E, Bowling MR. Malignancy in the tracheal bronchus: A case series and review of the literature. Clin Respir J, 2018, 12(9): 2441-2445.
19.	Wang Y, Cai S, Gao S, et al. Tracheobronchial adenoid cystic carcinoma: 50-year experience at the National Cancer Center, China. Ann Thorac Surg, 2019, 108(3): 873-882.
20.	Grillo HC, Mathisen DJ, Wain JC. Management of tumors of the trachea. Oncology (Williston Park), 1992, 6(2): 61-67.
21.	Gaissert HA, Grillo HC, Shadmehr MB, et al. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina. Ann Thorac Surg, 2004, 78(6): 1889-1896.
22.	Fux T, Österholm C, Themudo R, et al. Synthetic tracheal grafts seeded with bone marrow cells fail to generate functional tracheae: First long-term follow-up study. J Thorac Cardiovasc Surg, 2020, 159(6): 2525-2537.
23.	杜振宗, 任华, 张超纪, 等. 原发性气管和主支气管恶性肿瘤的外科治疗. 中华肿瘤杂志, 2009, 2(1): 152-155.

1. Nouraei SM, Middleton SE, Nouraei SA, et al. Management and prognosis of primary tracheal cancer: A national analysis. Laryngoscope, 2014, 124(1): 145-150.
2. Majeed FA, Zafar U, Ali A, et al. Emergency tracheal surgery for adenoid cystic carcinoma: A rare entity. J Coll Physicians Surg Pak, 2018, 28(11): 882-884.
3. Urdaneta AI, Yu JB, Wilson LD. Population based cancer registry analysis of primary tracheal carcinoma. Am J Clin Oncol, 2011, 34(1): 32-37.
4. Baig MZ, Weber JF, Connery CP, et al. A SEER database cohort of 868 patients with primary tracheal cancers: Characteristics and outcomes and the role of bronchoscopic interventions. IJS Oncology, 2020, 5(4): 90.
5. Wang HL, Xu L, Li FJ. Subglottic adenoid cystic carcinoma mistaken for asthma. J Zhejiang Univ Sci B, 2009, 10(9): 707-710.
6. Bhattacharyya N. Contemporary staging and prognosis for primary tracheal malignancies: A population-based analysis. Otolaryngol Head Neck Surg, 2004, 131(5): 639-642.
7. Scosyrev E, Messing J, Noyes K, et al. Surveillance Epidemiology and End Results (SEER) program and population-based research in urologic oncology: An overview. Urol Oncol, 2012, 30(2): 126-132.
8. Simoni P, Peters GE, Magnuson JS, et al. Use of the endoscopic microdebrider in the management of airway obstruction from laryngotracheal carcinoma. Ann Otol Rhinol Laryngol, 2003, 112(1): 11-13.
9. Shamji FM, Inculet R. Management of malignant tracheoesophageal fistula. Thorac Surg Clin, 2018, 28(3): 393-402.
10. Moores D, Mane P. Pathology of primary tracheobronchial malignancies other than adenoid cystic carcinomas. Thorac Surg Clin, 2018, 28(2): 149-154.
11. Honings J, Gaissert HA, Verhagen AF, et al. Undertreatment of tracheal carcinoma: Multidisciplinary audit of epidemiologic data. Ann Surg Oncol, 2009, 16(2): 246-253.
12. Xie L, Fan M, Sheets NC, et al. The use of radiation therapy appears to improve outcome in patients with malignant primary tracheal tumors: A SEER-based analysis. Int J Radiat Oncol Biol Phys, 2012, 84(2): 464-470.
13. Webb BD, Walsh GL, Roberts DB, et al. Primary tracheal malignant neoplasms: The University of Texas MD Anderson Cancer Center experience. J Am Coll Surg, 2006, 202(2): 237-246.
14. Jeremic B, Shibamoto Y, Acimovic L, et al. Radiotherapy for primary squamous cell carcinoma of the trachea. Radiother Oncol, 1996, 41(2): 135-138.
15. Chang CY, Cheng SL, Chang SC. Adenoid cystic carcinoma of trachea treated with tumor curettage and adjuvant intensity modulated radiation therapy. South Med J, 2011, 104(1): 68-70.
16. Spinelli GP, Miele E, Prete AA, et al. Combined surgery and radiotherapy as curative treatment for tracheal adenoid cystic carcinoma: A case report. J Med Case Rep, 2019, 13(1): 52.
17. 王洪武, 程庆好, 孔令煜, 等. 大力倡导加速康复外科在气管恶性肿瘤介入治疗中的应用. 中国肺癌杂志, 2019, 22(1): 1-5.
18. Levin E, Bowling MR. Malignancy in the tracheal bronchus: A case series and review of the literature. Clin Respir J, 2018, 12(9): 2441-2445.
19. Wang Y, Cai S, Gao S, et al. Tracheobronchial adenoid cystic carcinoma: 50-year experience at the National Cancer Center, China. Ann Thorac Surg, 2019, 108(3): 873-882.
20. Grillo HC, Mathisen DJ, Wain JC. Management of tumors of the trachea. Oncology (Williston Park), 1992, 6(2): 61-67.
21. Gaissert HA, Grillo HC, Shadmehr MB, et al. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina. Ann Thorac Surg, 2004, 78(6): 1889-1896.
22. Fux T, Österholm C, Themudo R, et al. Synthetic tracheal grafts seeded with bone marrow cells fail to generate functional tracheae: First long-term follow-up study. J Thorac Cardiovasc Surg, 2020, 159(6): 2525-2537.
23. 杜振宗, 任华, 张超纪, 等. 原发性气管和主支气管恶性肿瘤的外科治疗. 中华肿瘤杂志, 2009, 2(1): 152-155.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influencing factors for prognosis of primary tracheal malignancy and establishment of nomogram model for predicting its overall survival based upon SEER database

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