Zheng Shuai, Yang Jin, Li Chengzhuo, Han Didi, Xu Fengshuo, Elishilia Kaaya Rahel, ShengPeng Wang, Lyu Jun
Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China.
School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
J Oncol. 2021 Mar 26;2021:6676587. doi: 10.1155/2021/6676587. eCollection 2021.
We aimed to establish a prognostic model for gingival squamous cell carcinoma (GSCC) that was superior to traditional AJCC staging and to perform a comprehensive comparison of the newly established nomogram with the AJCC staging system.
We extracted 2,076 patients with gingival squamous cell carcinoma who had been entered into the SEER (Surveillance, Epidemiology, and End Results) database between 2004 and 2015, and randomly divided 70% of them into the training cohort and the other 30% into the validation cohort. Cox regression analysis was performed in combination with clinical experience and age, race, sex, marital status, tumor location, histological subtype, tumor grade, AJCC stage, chemotherapy status, radiotherapy status, and surgery status as possible prognostic factors. We evaluated and compared the two cohorts using the consistency index (C-index), area under the receiver operating characteristic curves, calibration curves, discriminant improvement index, and decision-curve analysis.
The Cox retrospective analysis showed that age, AJCC stage, tumor grade, histological subtype, radiotherapy status, and surgery status were significant factors to include in the new model of gingival squamous cell carcinoma. The other indicators were also better for the new model than for the AJCC staging system.
We have developed and validated a nomogram for performing reliable gingival squamous cell carcinoma prognoses. The prognostic value of the nomogram is higher than that of the AJCC staging system. We expect that the inclusion of more-comprehensive and authoritative data (i.e., not just limited to residents of the United States) would also allow the construction of reliable nomograms for other populations.
我们旨在建立一种优于传统美国癌症联合委员会（AJCC）分期的牙龈鳞状细胞癌（GSCC）预后模型，并将新建立的列线图与AJCC分期系统进行全面比较。
我们提取了2004年至2015年间纳入监测、流行病学和最终结果（SEER）数据库的2076例牙龈鳞状细胞癌患者，并将其中70%随机分为训练队列，另外30%分为验证队列。结合临床经验，将年龄、种族、性别、婚姻状况、肿瘤位置、组织学亚型、肿瘤分级、AJCC分期、化疗状态、放疗状态和手术状态作为可能的预后因素进行Cox回归分析。我们使用一致性指数（C指数）、受试者操作特征曲线下面积、校准曲线、判别改善指数和决策曲线分析对两个队列进行评估和比较。
Cox回顾性分析表明，年龄、AJCC分期、肿瘤分级、组织学亚型、放疗状态和手术状态是牙龈鳞状细胞癌新模型中应纳入的重要因素。新模型的其他指标也优于AJCC分期系统。
我们开发并验证了一种用于可靠预测牙龈鳞状细胞癌预后的列线图。该列线图的预后价值高于AJCC分期系统。我们期望纳入更全面、权威的数据（即不仅限于美国居民）也能为其他人群构建可靠的列线图。
