Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221117405. doi: 10.1177/15330338221117405.
The major salivary gland squamous cell carcinoma is a rare head and neck tumor, often accompanied by lymph node metastasis. Even if the patient undergoes surgery, the prognosis remains unsatisfactory. To explore the prognostic factors of postoperative major salivary gland squamous cell carcinoma to establish a prognostic risk stratification model to guide clinical practice. Patients' information was retrieved from the Surveillance, Epidemiology, and End Results database from 2004 to 2018. Optimal cutoff points were determined using X-tile software, and overall survival and disease-specific survival were calculated by the Kaplan-Meier method. Independent prognostic factors affecting the overall survival and disease-specific survival were identified by multivariate analysis, and corresponding 2 nomogram models were constructed. The discriminative ability and calibration of nomograms were evaluated by the Concordance index, area under curves, and calibration plots. A total of 815 patients with postoperative major salivary gland squamous cell carcinoma were enrolled. The cutoff values for the number of lymph nodes were 2, and the cutoff values for the lymph node ratio were 0.11 and 0.5, respectively. Age, T stage, tumor size, lymph nodes, lymph node ratio, and radiotherapy were prognostic factors for overall survival and disease-specific survival. Nomograms for disease-specific survival and overall survival were established and showed favorable performance with a higher Concordance index and area under curves than that of the tumor-node-metastasis stage and Surveillance, Epidemiology, and End Results stage. The calibration plots of 1-, 3-, and 5-year overall survival and disease-specific survival also exhibited good consistency. What's more, patients were divided into low-, moderate-, and high-risk groups according to the scores calculated by the models. The overall survival and disease-specific survival of patients in the high-risk group were significantly worse than those in the moderate- and low-risk group. Our nomogram integrated clinicopathological features and treatment modality to demonstrate excellent performance in risk stratification and prediction of survival outcomes in patients with major salivary gland squamous cell carcinoma after surgery, with important clinical value.
主要涎腺鳞状细胞癌是一种罕见的头颈部肿瘤，常伴有淋巴结转移。即使患者接受了手术，预后仍然不理想。本研究旨在探讨术后主要涎腺鳞状细胞癌的预后因素，建立预后风险分层模型，以指导临床实践。
从 2004 年至 2018 年，从监测、流行病学和最终结果数据库中检索患者信息。使用 X-tile 软件确定最佳截断值，通过 Kaplan-Meier 方法计算总生存率和疾病特异性生存率。通过多因素分析确定影响总生存率和疾病特异性生存率的独立预后因素，并构建相应的 2 个列线图模型。通过一致性指数、曲线下面积和校准图评估列线图的判别能力和校准度。
共纳入 815 例术后主要涎腺鳞状细胞癌患者。淋巴结数量的截断值为 2，淋巴结比率的截断值分别为 0.11 和 0.5。年龄、T 分期、肿瘤大小、淋巴结、淋巴结比率和放疗是总生存率和疾病特异性生存率的预后因素。建立了疾病特异性生存率和总生存率的列线图，其一致性指数和曲线下面积均高于肿瘤-淋巴结-转移分期和监测、流行病学和最终结果分期，表现出良好的性能。1、3 和 5 年总生存率和疾病特异性生存率的校准图也表现出良好的一致性。此外，根据模型计算的分数将患者分为低、中、高危组。高危组患者的总生存率和疾病特异性生存率明显差于中危组和低危组。
我们的列线图综合了临床病理特征和治疗方式，在风险分层和预测术后主要涎腺鳞状细胞癌患者的生存结果方面表现出优异的性能，具有重要的临床价值。
