涎腺主要癌症总生存、癌症特异性生存及复发列线图的验证
Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands.
作者信息
Hay Ashley, Migliacci Jocelyn, Zanoni Daniella Karassawa, Patel Snehal, Yu Changhong, Kattan Michael W, Ganly Ian
机构信息
Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Quantitative Health Services, Cleveland Clinic, Cleveland, Ohio.
出版信息
Head Neck. 2018 May;40(5):1008-1015. doi: 10.1002/hed.25079. Epub 2018 Feb 1.
BACKGROUND
The purpose of this study was to investigate the performance of the Memorial Sloan Kettering Cancer Center salivary carcinoma nomograms predicting overall survival, cancer-specific survival, and recurrence with an external validation dataset.
METHODS
The validation dataset comprised 123 patients treated between 2010 and 2015 at our institution. They were evaluated by assessing discrimination (concordance index [C-index]) and calibration (plotting predicted vs actual probabilities for quintiles).
RESULTS
The validation cohort (n = 123) showed some differences to the original cohort (n = 301). The validation cohort had less high-grade cancers (P = .006), less lymphovascular invasion (LVI; P < .001) and shorter follow-up of 19 months versus 45.6 months. Validation showed a C-index of 0.833 (95% confidence interval [CI] 0.758-0.908), 0.807 (95% CI 0.717-0.898), and 0.844 (95% CI 0.768-0.920) for overall survival, cancer-specific survival, and recurrence, respectively.
CONCLUSION
The 3 salivary gland nomograms performed well using a contemporary validation dataset, despite limitations related to sample size, follow-up, and differences in clinical and pathology characteristics between the original and validation cohorts.
背景
本研究旨在通过一个外部验证数据集来调查纪念斯隆凯特琳癌症中心唾液腺癌列线图预测总生存期、癌症特异性生存期和复发情况的性能。
方法
验证数据集包括2010年至2015年间在我们机构接受治疗的123例患者。通过评估区分度（一致性指数[C指数]）和校准度（绘制五分位数的预测概率与实际概率）对他们进行评估。
结果
验证队列（n = 123）与原始队列（n = 301）存在一些差异。验证队列中高级别癌症较少（P = 0.006），淋巴血管侵犯（LVI）较少（P < 0.001），随访时间较短，分别为19个月和45.6个月。验证显示，总生存期、癌症特异性生存期和复发的C指数分别为0.833（95%置信区间[CI] 0.758 - 0.908）、0.807（95% CI 0.717 - 0.898）和0.844（95% CI 0.768 - 0.920）。
结论
尽管存在样本量、随访以及原始队列和验证队列之间临床和病理特征差异等局限性，但使用当代验证数据集时，这3个唾液腺列线图表现良好。
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