Cheng Hao, Xu Xue-Lian
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Xinxiang, 453100, Henan, China.
Department of Radiotherapy Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China.
Discov Oncol. 2025 Jun 4;16(1):1001. doi: 10.1007/s12672-025-02869-6.
Lip squamous cell carcinoma (LSCC) is the most commonly occurring oral cavity cancer. This study aimed to establish and validate comprehensive nomograms for predicting the prognosis in postoperative LSCC patients.
A total of 136 postoperative LSCC patients diagnosed between June 2012 and June 2018 were enrolled from two medical institutions and randomly divided into the training and validation groups at a ratio of 7:3. According to the results of the univariate and multivariate Cox regression analyses, six independent indicators concerning overall survival (OS) were identified, including age, grade, T-stage, lymph node metastasis (LNM), perineural invasion (PNI), vascular invasion (VI), surgical margin. Besides, age, grade, T-stage, LNM, perineural invasion (PNI), and surgical margin were independent predictors of disease-free survival (DFS) in LSCC patients. The two nomograms for predicting OS and DFS were developed based on the above results.
The univariate and multivariate Cox regression analysis showed that higher pathological grade, age ≥ 70 years, higher T-stage, positive LNM, PNI, VI, and positive surgical margin were independent predictors of inferior OS. Meanwhile, higher pathological grade, age ≥ 70 years, higher T-stage, LNM, PNI, and positive surgical margin were independent predictors of inferior DFS. Based on the results above, two nomograms were constructed to predict 3- and 5-year OS and DFS in patients with LSCC. The C-indexes of the OS and DFS nomograms were 0.865 and 0.801 in the training group, and 0.915 and 0.815 in the validation group. The calibration curves showed satisfactory consistency between predicted and actual observed survival rates. The outperformance of the nomogram compared with the other predictors involved was shown by the decision curve analysis (DCA).
Two nomograms for predicting OS and DFS in patients with postoperative LSCC developed in this study perform well, which may be helpful for oncologists and surgeons to choose proper individual therapeutic schedules and design appropriate follow-up strategies.
唇鳞状细胞癌（LSCC）是最常见的口腔癌。本研究旨在建立并验证用于预测LSCC术后患者预后的综合列线图。
从两家医疗机构纳入2012年6月至2018年6月期间诊断的136例LSCC术后患者，并按7:3的比例随机分为训练组和验证组。根据单因素和多因素Cox回归分析结果，确定了6个与总生存期（OS）相关的独立指标，包括年龄、分级、T分期、淋巴结转移（LNM）、神经周围侵犯（PNI）、血管侵犯（VI）、手术切缘。此外，年龄、分级、T分期、LNM、神经周围侵犯（PNI）和手术切缘是LSCC患者无病生存期（DFS）的独立预测因素。基于上述结果绘制了预测OS和DFS的两个列线图。
单因素和多因素Cox回归分析显示，较高的病理分级、年龄≥70岁、较高的T分期、阳性LNM、PNI、VI和阳性手术切缘是OS较差的独立预测因素。同时，较高的病理分级、年龄≥70岁、较高的T分期、LNM、PNI和阳性手术切缘是DFS较差的独立预测因素。基于上述结果，构建了两个列线图以预测LSCC患者的3年和5年OS及DFS。训练组中OS和DFS列线图的C指数分别为0.865和0.801，验证组中分别为0.915和0.815。校准曲线显示预测生存率与实际观察生存率之间具有良好的一致性。决策曲线分析（DCA）表明列线图优于其他相关预测指标。
本研究中开发的用于预测LSCC术后患者OS和DFS的两个列线图性能良好，可能有助于肿瘤学家和外科医生选择合适的个体化治疗方案并设计适当的随访策略。
