Zhang Jiahui, Su Wenjun, Wang Yue, Zeng Peiji, Wang Wei, Fu Wenjie, Cai Chengfu
Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China.
Department of Otolaryngology-Head and Neck Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Discov Oncol. 2025 Apr 2;16(1):452. doi: 10.1007/s12672-025-02193-z.
Traditionally, the AJCC TNM staging system has been the primary tool for assessing the severity and prognosis of laryngeal cancer. Although several studies have demonstrated that the log odds of positive lymph nodes (LODDS) offers superior predictive accuracy compared to the TNM staging for other cancers, there is limited research for laryngeal cancer. This study analyzed data from SEER database (2000-2019). Independent risk factors for survival were identified using univariate and multivariate Cox regression analyses, and different prognostic models were constructed based on the multivariate analysis results. The predictive performance of these models was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC) values. The results indicated that LODDS subgroup, age, marital status, histologic grade, T-stage, and N-stage were consistent independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Assessment metrics showed that the multivariate model, which incorporated both LODDS and N staging, outperformed the individual N staging and LODDS models in predicting postoperative prognosis in laryngeal cancer patients. Overall, the multivariate model constructed in this study is a superior tool for predicting the postoperative status of laryngeal cancer.
传统上，美国癌症联合委员会（AJCC）的TNM分期系统一直是评估喉癌严重程度和预后的主要工具。尽管多项研究表明，与TNM分期相比，阳性淋巴结对数优势比（LODDS）对其他癌症具有更高的预测准确性，但针对喉癌的相关研究却很有限。本研究分析了监测、流行病学和最终结果（SEER）数据库（2000 - 2019年）中的数据。使用单因素和多因素Cox回归分析确定生存的独立危险因素，并根据多因素分析结果构建不同的预后模型。使用受试者工作特征（ROC）曲线和曲线下面积（AUC）值评估这些模型的预测性能。结果表明，LODDS亚组、年龄、婚姻状况、组织学分级、T分期和N分期是总生存期（OS）和癌症特异性生存期（CSS）一致的独立预后因素。评估指标显示，结合了LODDS和N分期的多因素模型在预测喉癌患者术后预后方面优于单独的N分期和LODDS模型。总体而言，本研究构建的多因素模型是预测喉癌术后状况的更优工具。
