(K128780) Támogató: Nemzeti Kutatás, Fejlesztés és Innovációs Iroda
(RRF-2.3.1-21-2022-00006) Támogató: Egészségbiztonság Nemzeti Laboratórium
During the progress of oncological diseases, there is an increased probability that
spinal metastases may develop, requiring personalised treatment options. Risk calculator
systems aim to provide assistance in the therapeutic decision-making process by estimating
survival chances. The predictive ability of such calculators can be improved, thereby
optimising the choice of personalised therapy. The aim of this research was to create
a new risk assessment system and show a method with which other centres can develop
their own local score.We created a database by retrospectively processing 454 patients.
The prognostic factors were selected via a network science-based correlation analysis
that maximises Uno's C-index, keeping only a small number of predictors. To validate
the new system, we calculated the D-statistic, the Integrated Discrimination Index,
made a five-fold cross-validation and also calculated the integrated time-dependent
Brier score.As a result of multivariate Cox analysis, we found five independent prognostic
factors suitable for the design of the risk calculator. This new system has a better
predictive ability compared with six other well-known systems with an average C-index
of 0.706 at 10 years (95% confidence interval 0.679-0.733).An accurate estimation
of the life expectancy of cancer patients is essential for the implementation of personalised
medicine. The training performance of our system is encouraging, indicating the benefit
of a network science-based visualisation step. We believe that in order to further
improve the prediction ability, it is necessary to systematise previously 'unknown'
factors (e.g. radiological morphology).
