为了全面分析手术依从性对胶质瘤患者生存率的影响，并探讨影响手术依从性的因素，我们从Surveillance, Epidemiology, and End Results (SEER)数据库中收集了2004年至2018年间胶质瘤患者的临床数据。采用Kaplan-Meier曲线和Cox回归分析手术依从性对总生存期(OS)和疾病特异性生存期(DSS)的影响。采用多变量Cox回归分析选择预测变量并构建诺模图。采用Harell一致性指数(C-index)、决策曲线分析(DCA)、接受者操作特征(ROC)曲线和校准曲线评估这些模型的预测能力。通过多元 logistic 回归分析相关变量以及1:1倾向得分匹配(PSM)来评估有良好和差的手术依从性患者结果的有效性。 在符合条件的47,573名胶质瘤患者中，有46,380名（97.5%）属于手术依从性组，而1193名（2.5%）属于非依从性组。手术依从性是胶质瘤患者的独立预后因子，多变量Cox回归分析显示，与无手术依从性的患者相比，具有手术依从性的患者的OS (风险比[HR] 1.924；95%置信区间[CI] 1.800-2.056，p < 0.001)和DSS (HR 1.718; 95% CI 1.592-1.853，p < 0.001)更差。我们开发并内部验证了一个能够预测胶质瘤预后的诺模图。该诺模图可以很好地预测患者的OS(C-index: 0.745)和DSS(C-index: 0.744)。ROC曲线、DCA曲线和校准曲线被应用于进一步评估诺模图的准确性。发现差的手术依从性与年龄较大、女性性别、肿瘤直径、二级及以上分级、差分级、肿瘤位于小脑和脑干、低家庭收入有关。 手术依从性是胶质瘤患者OS和DSS的独立预后因子，而良好的手术依从性与良好的生存显著相关。 © 2023. 本文作者，独家许可给Springer-Verlag GmbH Germany的一部分，归Springer Nature版权所有。

To comprehensively analyze the impact of surgical compliance on the survival of patients with glioma and to explore the factors that influence surgical compliance.Clinical data of patients with glioma between 2004 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox regression were used to analyze the effect of surgical compliance on overall survival (OS) and disease-specific survival (DSS). Multivariate Cox regression was used to select the prediction variables and construct the nomograms. The predictive power of these models was assessed using Harell's consistency index (C-index), decision curve analysis (DCA), receiver operating characteristic (ROC) curves, and calibration curves. Multivariate logistic regression was performed to analyze the related variables of surgical compliance, and 1:1 propensity score matching (PSM) was applied to evaluate the validity of the results of patients with favorable and poor surgical compliance.Among the 47,573 eligible glioma patients recommended for surgery, 46,380 (97.5%) were in the surgical compliance group, while 1193 (2.5%) were in the noncompliance group. Surgical compliance was an independent prognostic factor for glioma patients, as indicated by multivariate Cox regression analysis that patients with surgical compliance had worse OS (hazard ratio [HR] 1.924; 95% confidence interval [CI] 1.800-2.056, p < 0.001) and DSS (HR 1.718; 95% CI 1.592-1.853, p < 0.001) in comparison to those without surgical compliance. A nomogram was developed and internally validated to be able to predict glioma prognosis. The nomogram can well predict patients' OS (C-index: 0.745) and DSS (C-index: 0.744). ROC curve, DCA curve, and calibration curve were applied to further assess the accuracy of the nomogram. Poor surgical compliance was found to be related to older age, female gender, tumor diameter, grade II or higher, poor grading, tumor location in the cerebellum and brainstem, and low household income.Surgical compliance is an independent prognostic factor for predicting the OS and DSS of patients with glioma, and good surgical compliance was significantly related to good survival.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.