Gupta Supriya, Waller Jennifer, Brown Jimmy, Elam Yolanda, Rawson James V, Pucar Darko
Amita Presence St. Mary's Hospital, 500 West court street, Kankakee, IL 60901 USA.
Augusta University Medical Center, 1120 15th Street, Augusta, GA 30912 USA.
Indian J Otolaryngol Head Neck Surg. 2020 Jun;72(2):160-168. doi: 10.1007/s12070-019-01726-7. Epub 2019 Aug 16.
Our goal was to determine the most important predictors and construct a nomogram for overall survival (OS) in oral cavity squamous cell cancer (OCSCC) treated with primary surgery followed by observation, adjuvant radiation or chemoradiation. Multivariable analysis was performed using Cox Proportional Hazard model of 9258 OCSCC patients from Surveillance, Epidemiology and End Results Program (SEER) database treated with surgery from 2003 to 2009. Potential predictors of OS were age, gender, race, tobacco use, oral cancer sub-sites, pathologic tumor stage and grade, pathologic nodal stage, extra-capsular invasion, clinical levels IV and V involvement, and adjuvant treatment selection. Weighted propensity scores for treatment were used to balance observed baseline characteristics between three treatment groups in order to reduce bias. Following primary surgery, patients underwent observation (56%), radiation alone (31%) or chemoradiation (13%). All tested predictors were statistically significant and included in our final nomogram. Most important predictor of OS was age, followed by pathologic tumor stage. SEER based-survival nomogram for OCSCC patients differs from published models derived from patients treated in a single or few academic treatment centers. An unexpected finding of patient age being the best OS predictor suggests that this factor may be more critical for the outcome than previously anticipated.
我们的目标是确定口腔鳞状细胞癌（OCSCC）接受原发手术后观察、辅助放疗或放化疗患者总生存期（OS）的最重要预测因素，并构建列线图。使用监测、流行病学和最终结果计划（SEER）数据库中2003年至2009年接受手术治疗的9258例OCSCC患者的Cox比例风险模型进行多变量分析。OS的潜在预测因素包括年龄、性别、种族、吸烟情况、口腔癌亚部位、病理肿瘤分期和分级、病理淋巴结分期、包膜外侵犯、临床IV和V级受累以及辅助治疗选择。使用治疗的加权倾向评分来平衡三个治疗组之间观察到的基线特征，以减少偏差。原发手术后，患者接受观察（56%）、单纯放疗（31%）或放化疗（13%）。所有测试的预测因素均具有统计学意义，并纳入我们最终的列线图。OS的最重要预测因素是年龄，其次是病理肿瘤分期。基于SEER的OCSCC患者生存列线图与来自单个或少数学术治疗中心治疗患者的已发表模型不同。患者年龄是最佳OS预测因素这一意外发现表明，该因素对预后的影响可能比先前预期的更为关键。
