Abstract
To the best of our knowledge, this is the first study established a nomogram to predict survival probability in Asian patients with LSCC. A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application.Background: Due to a wide variation of tumor behavior, prediction of survival in laryngeal squamous cell carcinoma (LSCC) patients received curative-intent surgery is an important but formidable challenge. We attempted to establish a nomogram to precisely predict survival probability in LSCC patients.Methods: A total of 369 consecutive LSCC patients underwent curative resection between 2008 and 2012 at Hunan Province Cancer Hospital were included in the present study. Subsequently, 369 LSCC patients were assigned to a training set (N=261) and a validation set (N=108) at random. On the basis of multivariable Cox regression analysis results, we developed a nomogram. The predictive accuracy and discriminative ability of the nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis.Results: Six independent parameters to predict prognosis were age, pack years, N-stage, lymph node ratio (LNR), anemia and albumin, which were all assembled into the nomogram. The calibration curve verified excellent models’ concordance. The C-index of the nomogram was 0.73 (0.68–0.78), and the area under curve (AUC) of nomogram in predicting overall survival (OS) was 0.766, which were significantly higher than traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had a larger net benefit than the TNM stage.Conclusion: A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application.
Highlights
Laryngeal squamous cell carcinoma (LSCC) is among the most frequently diagnosed head and neck squamous cell cancers (HNSCC), with almost 26,300 new cases and about 14,500 deaths in China in 2015License 4.0 (CC BY).[1]
The inclusion criteria were as follows: (a) patients were older than 18 years old; (b) patients with LSCC diagnosed by multidisciplinary teams, including clinicians, radiologist and pathologist; (c) without neoadjuvant chemotherapy or radiotherapy before underwent laryngectomy
The analysis data set was collected in University of Michigan Health System, which included 246 cases confirmed by biopsy, TNM stage I to IVb, previously untreated with laryngeal squamous cell carcinoma between 2003 and 2014
Summary
Laryngeal squamous cell carcinoma (LSCC) is among the most frequently diagnosed head and neck squamous cell cancers (HNSCC), with almost 26,300 new cases and about 14,500 deaths in China in 2015License 4.0 (CC BY).[1]. The 5-year overall survival rate varies between approximately 50% and 60%, depending on treatment model, tumor-related factors, and patient-related factors [2]. A variety of treatments are applied to cure LSCC patients, including surgery, radiotherapy and chemotherapy [3]. The 5-year survival rate was still on the decline according to the review of American Cancer Society [4,5]. On account of a broad spectrum of tumor histological subtypes and diverse clinical behaviors, the prediction of survival risk in patients with LSCC is a difficult task for clinicians. It is of great importance to identify reliable and convenient predictive parameters/models to predict survival and optimize therapeutic strategies in LSCC patients
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