Abstract
BackgroundThe aim of this study was to evaluate the prognostic value of radiomics signature and nomogram based on contrast-enhanced computed tomography (CT) in patients after surgical resection of laryngeal squamous cell carcinoma (LSCC).MethodsAll patients (n = 136) were divided into the training cohort (n = 96) and validation cohort (n = 40). The LASSO regression method was performed to construct radiomics signature from CT texture features. Then a radiomics nomogram incorporating the radiomics signature and clinicopathologic factors was established to predict overall survival (OS). The validation of nomogram was evaluated by calibration curve, concordance index (C-index) and decision curve.ResultsBased on three selected texture features, the radiomics signature showed high C-indexes of 0.782 (95%CI: 0.656–0.909) and 0.752 (95%CI, 0.614–0.891) in the two cohorts. The radiomics nomogram had significantly better discrimination capability than cancer staging in the training cohort (C-index, 0.817 vs. 0.682; P = 0.009) and validation cohort (C-index, 0.913 vs. 0.699; P = 0.019), as well as a good agreement between predicted and actual survival in calibration curves. Decision curve analysis also suggested improved clinical utility of radiomics nomogram.ConclusionsRadiomics signature and nomogram showed favorable prediction accuracy for OS, which might facilitate the individualized risk stratification and clinical decision-making in LSCC patients.
Highlights
The aim of this study was to evaluate the prognostic value of radiomics signature and nomogram based on contrast-enhanced computed tomography (CT) in patients after surgical resection of laryngeal squamous cell carcinoma (LSCC)
It is well known that the development, therapeutic response and prognosis of tumors are associated with the intratumoral heterogeneity, such as gene mutationexpression, cellular histology, angiogenesis and tumor microenvironment [7]
Based on CT texture analysis, intratumoral heterogeneity can be translated into the heterogeneity in spatial distribution of density pixels, which was related with pathological grade, tumor aggressiveness, tumoral biological index as well as prognosis and therapeutic response [28,29,30]
Summary
The aim of this study was to evaluate the prognostic value of radiomics signature and nomogram based on contrast-enhanced computed tomography (CT) in patients after surgical resection of laryngeal squamous cell carcinoma (LSCC). Recent studies have focused on the texture analysis of computed tomography (CT), which showed the potential prognostic value in several tumors, including lung cancer and liver cancer [8, 9]. The radiomics analyses are performed on image processing systems to estimate the texture features in CT images of tumors, and represent the intratumoral heterogeneity [11, 12]. Published studies have suggested that radiomics nomogram had significant predictive accuracy for lymph node metastasis and survival outcomes in cancer patients [13, 14]
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