Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Xinxiang, 453100, Henan, China.
Department of Otolaryngology, AnYang District Hospital, Anyang, 455000, Henan, China.
BMC Cancer. 2024 Jun 14;24(1):730. doi: 10.1186/s12885-024-12465-6.
Oral cavity squamous cell carcinoma (OCSCC) is the most common pathological type in oral tumors. This study intends to construct a novel prognostic nomogram model based on China populations for these resectable OCSCC patients, and then validate these nomograms.
A total of 607 postoperative patients with OCSCC diagnosed between June 2012 and June 2018 were obtained from two tertiary medical institutions in Xinxiang and Zhengzhou. Then, 70% of all the cases were randomly assigned to the training group and the rest to the validation group. The endpoint time was defined as overall survival (OS) and disease-free survival (DFS). The nomograms for predicting the 3-, and 5-year OS and DFS in postoperative OCSCC patients were established based on the independent prognostic factors, which were identified by the univariate analysis and multivariate analysis. A series of indexes were utilized to assess the performance and net benefit of these two newly constructed nomograms. Finally, the discrimination capability of OS and DFS was compared between the new risk stratification and the American Joint Committee on Cancer (AJCC) stage by Kaplan-Meier curves.
607 postoperative patients with OCSCC were selected and randomly assigned to the training cohort (n = 425) and validation cohort (n = 182). The nomograms for predicting OS and DFS in postoperative OCSCC patients had been established based on the independent prognostic factors. Moreover, dynamic nomograms were also established for more convenient clinical application. The C-index for predicting OS and DFS were 0.691, 0.674 in the training group, and 0.722, 0.680 in the validation group, respectively. Besides, the calibration curve displayed good consistency between the predicted survival probability and actual observations. Finally, the excellent performance of these two nomograms was verified by the NRI, IDI, and DCA curves in comparison to the AJCC stage system.
The newly established and validated nomograms for predicting OS and DFS in postoperative patients with OCSCC perform well, which can be helpful for clinicians and contribute to clinical decision-making.
口腔鳞状细胞癌(OCSCC)是口腔肿瘤中最常见的病理类型。本研究旨在构建一个基于中国人群的可切除 OCSCC 患者的新的预后列线图模型,并对这些列线图进行验证。
本研究共纳入 2012 年 6 月至 2018 年 6 月在新乡和郑州两家三级医疗机构接受治疗的 607 例术后 OCSCC 患者。然后,将所有患者随机分为训练组(n=425)和验证组(n=182),其中 70%的患者被随机分配到训练组,其余的患者被分配到验证组。终点时间定义为总生存(OS)和无病生存(DFS)。基于单因素和多因素分析确定的独立预后因素,建立了预测术后 OCSCC 患者 3 年和 5 年 OS 和 DFS 的列线图。利用一系列指标评估了这两个新构建的列线图的性能和净效益。最后,通过 Kaplan-Meier 曲线比较了新的风险分层和美国癌症联合委员会(AJCC)分期对 OS 和 DFS 的区分能力。
本研究共纳入 607 例 OCSCC 术后患者,其中 425 例患者被随机分配到训练组,182 例患者被随机分配到验证组。基于独立的预后因素,建立了预测术后 OCSCC 患者 OS 和 DFS 的列线图。此外,还建立了动态列线图,以方便临床应用。在训练组中,预测 OS 和 DFS 的 C 指数分别为 0.691 和 0.674,在验证组中,预测 OS 和 DFS 的 C 指数分别为 0.722 和 0.680。此外,校准曲线显示预测生存概率与实际观察之间具有良好的一致性。最后,通过 NRI、IDI 和 DCA 曲线与 AJCC 分期系统相比,验证了这两个列线图的优异性能。
本研究构建的新的可切除 OCSCC 患者术后 OS 和 DFS 预测列线图模型具有良好的预测性能,可帮助临床医生进行决策。