Secondary Logo

Journal Logo

doi: 10.1097/MD.0000000000017332
Research Article: Observational Study

To predict the survival of appendiceal mucinous adenocarcinoma (AMA) by prognostic nomogram.

A total of 3234 patients with AMA were collected from the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2015. Univariate and multivariate Cox proportional hazards (PH) regression analyses were used to generate independent prognostic factors. These variables were included in the nomogram to predict overall survival (OS) and disease-specific survival (DSS) at 1-, 3-, and 5- years. These data are validated both internally and externally. The consistency index (C-index) and calibration chart were used to estimate the accuracy of the nomogram.

The study cohort was randomly divided into the training (n = 2155) and validation group (n = 1799). According to univariate and multivariate analyses, age at diagnosis, marital status, sex, histological differentiation, SEER extent of disease, number of local lymph nodes examined, whether they were positive, and surgical methods were independent prognostic factors for OS and DSS. These factors were incorporated into the nomogram. Internal validation in the training cohort showed that the C-index values for nomogram predictions of OS and DSS were 0.73 (95% CI 0.70–0.76) and 0.77 (95% CI 0.73–0.81), respectively. Similarly, the corresponding C-index values in the external validation cohort were 0.76 (95% CI 0.70–0.81) and 0.75 (95% CI 0.71–0.80). The Calibration plots revealed that the actual survival and nomogram prediction had a good consistency.

Build a nomogram in the SEER database to predict OS and DSS in patients with AMA. It can provide accurate and personalised survival prediction for clinicians and patients.

aGuangzhou University of Chinese Medicine

bThe First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

∗Correspondence: Xiong Wen Wang, The Second District of Cancer Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China (e-mail:

Abbreviations: AJCC = American Joint Committee on Cancer, AMA = appendiceal mucinous adenocarcinoma, CEA = carcinoembryonic antigen, CI = confidence interval, C-index = consistency index, CSS/DSS = cancer-specific survival/disease-specific survival, HR = hazard ratio, OS = overall survival, PH = proportional hazards, SEER = Surveillance, Epidemiology, and End Results.

How to cite this article: Yan Q, Zheng WJ, Chen QL, Wang BQ, Luo HY, Xue J, Wang XW. Nomogram to predict overall survival and disease-specific survival with appendiceal mucinous adenocarcinoma. Medicine. 2019;98:40(e17332).

This work is supported by Guangzhou University of Chinese Medicine, First-class Discipline Research Key Project (A1-AFD018181A29).

The authors have no conflicts of interest to disclose.

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.


    appendiceal mucinous adenocarcinoma; cancer-specific survival; nomogram; overall survival; SEER database

    Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.