Xu Qing-Qing, Li Qing-Jie, Chen Liu, Su Xin-Yi, Song Jing-Xia, Du Juan, Chen Lei, Lu Li-Xia
Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430079, Hubei, China.
Cancer Cell Int. 2021 Apr 17;21(1):224. doi: 10.1186/s12935-021-01927-7.
We aimed to understand the clinical characteristics and better predict the prognosis of patients with mucosal melanoma of the head and neck (MMHN) using a nomogram.
Three hundred patients with nometastatic MMHN were included. Multivariable Cox regression was performed to analyze independent prognostic factors for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS), and these factors were used to develop a nomogram. Concordance indexes (C-indexes), calibration plots, and receiver operating characteristic (ROC) analysis were performed to test the predictive performance of the nomogram in both the primary (n = 300) and validation cohorts (n = 182).
The primary tumor site, T stage and N stage were independent risk factors for survival and were included in the nomogram to predict the 3- and 5-year OS, DFS, DMFS, and LRRFS in the primary cohort. The C-indexes (both > 0.700), well-fit calibration plots, and area under the ROC curve (both > 0.700) indicated the high diagnostic accuracy of the nomogram, in both the primary and validation cohorts. The patients were divided into three groups (high-risk, intermediate-risk, and low-risk groups) according to their nomogram scores. The survival curves of OS, DFS, DMFS, and LRRFS were well separated by the risk groups in both cohorts (all P < 0.001).
The nomogram can stratify MMHN patients into clinically meaningful taxonomies to provide individualized treatment.
我们旨在通过列线图了解头颈部黏膜黑色素瘤（MMHN）患者的临床特征，并更好地预测其预后。
纳入300例非转移性MMHN患者。进行多变量Cox回归分析以确定总生存（OS）、无病生存（DFS）、无远处转移生存（DMFS）和无局部区域复发生存（LRRFS）的独立预后因素，并将这些因素用于构建列线图。进行一致性指数（C指数）、校准曲线和受试者工作特征（ROC）分析，以检验列线图在原发队列（n = 300）和验证队列（n = 182）中的预测性能。
原发肿瘤部位、T分期和N分期是生存的独立危险因素，并被纳入列线图以预测原发队列中3年和5年的OS、DFS、DMFS和LRRFS。C指数（均>0.700）、拟合良好的校准曲线以及ROC曲线下面积（均>0.700）表明列线图在原发队列和验证队列中均具有较高的诊断准确性。根据列线图评分将患者分为三组（高风险、中风险和低风险组）。两个队列中，OS、DFS、DMFS和LRRFS的生存曲线在不同风险组之间有明显区分（均P<0.001）。
列线图可将MMHN患者分层为具有临床意义的分类，以提供个体化治疗。
