Li Yun, Ju Jun, Liu Xiaoxiao, Gao Tao, Wang Zhidong, Ni Qianwei, Ma Chao, Zhao Zhenyan, Ren Yixiong, Sun Moyi
State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China.
Department of Otolaryngology Head and Neck Surgery, Navy General Hospital, Beijing, China.
Oncotarget. 2017 Apr 11;8(15):24469-24482. doi: 10.18632/oncotarget.14905.
In this study, we aimed to develop and validate nomograms for predicting long-term overall survival (OS) and cancer-specific survival (CSS) in major salivary gland cancer (MSGC) patients. These nomograms were developed using a retrospective cohort (N=4218) from the Surveillance, Epidemiology, and End Results (SEER) database, and externally validated using an independent data cohort (N=244). We used univariate, and multivariate analyses, and cumulative incidence function to select the independent prognostic factors of OS and CSS. Index of concordance (c-index) and calibration plots were used to estimate the nomograms' predictive accuracy. The median follow-up period was 34 months (1-119 months). Of 4218 MSGC patients, 1320 (31.3%) died by the end of the follow-up; of these 1320 patients, 883 (20.9%) died of MSGC. The OS nomogram, which had a c-index of 0.817, was based on nine variables: age, sex, tumor site, tumor grade, surgery performed, radiation therapy and TNM classifications. The CSS nomogram, which had a c-index of 0.829, was based on the same nine variables plus race. External validation c-indexes were 0.829 and 0.807 for OS and CSS, respectively. Based on SEER database, we have developed nomograms predicting five- and eight-years OS and CSS for MSGC patients with perfect accuracy. These nomograms will help clinicians customize treatment and monitoring strategies in MSGC patients.
在本研究中，我们旨在开发并验证用于预测大唾液腺癌（MSGC）患者长期总生存期（OS）和癌症特异性生存期（CSS）的列线图。这些列线图是使用来自监测、流行病学和最终结果（SEER）数据库的回顾性队列（N = 4218）开发的，并使用独立数据队列（N = 244）进行外部验证。我们使用单变量和多变量分析以及累积发病率函数来选择OS和CSS的独立预后因素。一致性指数（c指数）和校准图用于估计列线图的预测准确性。中位随访期为34个月（1 - 119个月）。在4218例MSGC患者中，1320例（31.3%）在随访结束时死亡；在这1320例患者中，883例（20.9%）死于MSGC。OS列线图的c指数为0.817，基于九个变量：年龄、性别、肿瘤部位、肿瘤分级、所进行的手术、放射治疗和TNM分类。CSS列线图的c指数为0.829，基于相同的九个变量加上种族。OS和CSS的外部验证c指数分别为0.829和0.807。基于SEER数据库，我们开发了列线图，可完美准确地预测MSGC患者的5年和8年OS及CSS。这些列线图将有助于临床医生为MSGC患者定制治疗和监测策略。
