Development and validation of nomogram for predicting prognosis of patients with laryngeal squamous cell carcinoma after surgery

Abstract

Objective:To explore the relationship between preoperative blood indexes, clinicopathological characteristics and prognosis of patients with laryngeal squamous cell carcinoma（LSCC）, and to establish a nomogram for predicting survival and recurrence time of LSCC patients. Methods:The clinical data of 530 patients with LSCC who received primary surgical treatment were analyzed retrospectively. The patients were randomly divided into training group and testing group according to the ratio of 7∶3. The nomograms of overall survival（OS） and recurrence-free survival（RFS） were constructed based on Cox regression model, and the nomograms were verified and compared with TNM stage. Results:The results of multivariate analysis showed that age, operation mode, tumor diameter, TNM stage, cervical lymph node metastasis, fibrinogen level and systemic immune inflammation index were significantly correlated with OS, while operation mode, tumor diameter, TNM stage, cervical lymph node metastasis, international normalized ratio, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly correlated with RFS. The nomograms were constructed based on the above factors. The C-indexes of the nomograms of OS and RFS in the training group were 0.755 and 0.687, respectively, which were higher than those of TNM stage（0.657 and 0.582）. In the testing group, the C-indexes of OS and RFS nomograms were 0.717 and 0.646, respectively, which were higher than those of TNM stage（0.599 and 0.528）. The area under the receiver operating characteristic curves of these nomograms were also higher than TNM stage. The calibration curves showed that the models had good consistency. Decision curve analysis（DCA） showed that these nomograms had higher clinical benefit than TNM stage. Conclusion:Based on the independent prognostic factors, the predictive nomograms of OS and RFS at 1, 3 and 5 years after LSCC were constructed, which have certain clinical significance in guiding the individualized diagnosis and treatment of LSCC.