Risk Analysis of Distal Metastasis in Chondrosarcoma and the Development and Validation of a Novel Clinical Prediction Model: A Clinical Study Based on the SEER Database

Purpose. Distal metastasis in chondrosarcoma is associated with a poor prognosis. The aim of this study was to develop and validate columnar maps to predict the risk of distal metastasis in patients with chondrosarcoma, thereby contributing to clinical diagnosis and treatment. Methods. Data from chondrosarcoma patients obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016 were then screened by univariate and multifactorial logistic regressions to construct a predictive distal metastasis risk. The model discrimination of nomogram was assessed by calibration plots, while the predictive accuracy and clinical values were measured by decision curve analysis (DCA). In addition, predictive column line plots were validated in an in-house test set. Results. A total of 1,290 patients were included and randomized in a 7 to 3 ratio into a training group (n = 906) and a test group (n = 384). After logistic regression analysis, the significant variables were gender, tumor pathological grade, laterality, primary tumor stage, regional lymph node metastasis, surgical treatment, and chemotherapy. Calibration curves showed agreement between column line graph predictions and actual observations, while DCA showed the clinical utility of the nomogram. In addition, ROC showed good discrimination and calibration in the training (AUC = 0.937, 95% CI 0.919–0.952) and validation groups (AUC = 0.91, 95% CI 0.877–0.937). Conclusions. The nomogram for distal metastasis risk in patients with chondrosarcoma can effectively predict the individualized risk of distal metastasis and provide clinicians with enlightening information to optimize treatment options.