Discussion
tumor, cancer, necrotic, CVC tumor, nonmelanoma skin cancer, tumors
TUMOR, METASTASIS, RECURRENCE, CANCER, NECROTIC, NONMELANOMA SKIN CANCER, TUMORS, METASTASES
With a lifetime prevalence of 7–11% in the USA, CVC is the second-most prevalent nonmelanoma skin cancer among white people (This study effectively used case data from the SEER database to construct a unique and simple prediction nomogram for patients with CVC. The 3-, 5-, and 8-year OS probabilities of patients with CVC can be estimated using this nomogram. In both internal and external evaluation, our nomogram showed satisfactory accuracy and discrimination. Nomograms can be used to identify and categorize participants in clinical trials to produce personalized prognostics. It is important for both the physician and the patient to properly interpret the probability of the 3-, 5-, or 8-year recurrence for the patient (Our study found that the average age at which CVC was diagnosed was 67 years, with males comprising the majority (>50%) of cases in both cohorts (It was particularly interestingly that this study found that having experienced divorce is a risk factor for the OS (HR = 1.356, p < 0.05) in CVC. A previous study found that divorced patients with cancer had worse outcomes than married patients (Clinically, an CVC tumor lesion is defined by progression to a large, necrotic, and infected state with local aggressive metastasis, with results that are comparable to those of our study. Although uncommon, metastases to nearby lymph nodes and other distant regions are possible. Metastatic CVC has a fatal prognosis; our nomogram indicated that distant tumors in CVC increases negative outcomes for the survival rate, with a few large studies indicating mortality rates of 70% (Our investigation found that patients who underwent surgery had an improved prognosis (A nomogram for OS has been constructed based on an assessment of the relevant prognostic indicators, and the nomogram was compared with the standard AJCC model by employing an internal validation cohort and a training cohort. The C-index and AUC were utilized to assess the discrimination abilities of the two approaches, and we discovered that both of these were superior for the monogram compared with the AJCC staging system in both the training and validation cohorts (In order to establish the accuracy of our nomogram, the calibration curves and C-indexes were checked using both the training and validation cohorts. When subjected to internal and external validation, the C-indexes for the 3-, 5-, and 8-year OS models were 0.737 and 0.735, respectively. Both internal and external verification methodologies indicated that the C-index of the OS model exceeded 0.7. Excellent performance of the nomogram was also demonstrated by the calibration curves being highly consistent with the 45-degree ideal lines. These outcomes demonstrated that in both the training and verification cohorts, our nomogram had good calibration and discrimination performance (Decision-curve analysis (DCA) was employed to assess the clinical net benefit of the prediction models (While our study had important strengths, there were also a few limitations. First, because of the retrospective design of extracting data from the SEER database, selection and information biases were unavoidable. Second, therapy information in the SEER database is not all-inclusive; for example, no information was available on the type of surgical techniques utilized or some crucial clinical pathologic characteristics associated with prognoses, such as vascular invasion and the surgical margin. Third, the SEER database information lacks some laboratory tests results for important prognostic indicators, such as tumor and immunohistochemical analyses markers of p53, Rb gene, and HMB-45. Fourth, the projected values of the nomogram are only intended to serve as a general reference for doctors and will not always provide a correct prognosis. Future prospective studies will be conducted to test the nomogram to account for these limitations.