Discussion
cancer, deaths
CANCER
COCA is the fifth leading cause of cancer-related deaths worldwide (Sung et al. The dataset not stratified by age in this study is one in which the study cohort was not grouped based on age. Many previous studies have demonstrated that for cancer patients, older adults have a shorter OS survival than their younger opposites (Tai et al. In this study, the relationship between sex and prognosis of COCA patients was not significant. However, demographic variables such as sex and race are one of essential variables in cancer treatment (Goggins and Lo The TNM staging system is the standard method for staging COCA (Hari et al. This study had several limitations. First, given that it was a retrospective study, selection bias in the patient selection process cannot be ruled out. In addition, due to the limited clinical information on patients in the SEER database, more valuable clinical factors, such as specific radiation treatment regimens, surgical access, were not considered in the analysis. Finally, the accuracy of our nomogram was not validated with external data. To override this limitation, our study cohort was divided into the training and validation cohort in a ratio of 7:3, in which the 30% of the population was used for internal validation. The results of the internal validation demonstrated the robustness of the model. Despite these drawbacks, our study has some clear advantages. First, this study included sufficient data, which increased the reliability of our findings. Second, we constructed three nomograms simultaneously, which not only made the results more comparable but also illustrated some differences in the factors that impact prognosis between early-onset COCA and late-onset COCA. Third, the model's accuracy was validated, further demonstrating the stability and reliability of the constructed models. Finally, the dynamic nomograms could predict the OS of COCA patients at all ages.