Abstract
BackgroundOral tongue squamous cell carcinoma (OTSCC) is a prevalent malignant disease that is characterized by high rates of metastasis and postoperative recurrence. The aim of this study was to establish a nomogram to predict the outcome of OTSCC patients after surgery.MethodsWe retrospectively analyzed 169 OTSCC patients who underwent treatments in the Cancer Hospital of Shantou University Medical College from 2008 to 2019. The Cox regression analysis was performed to determine the independent prognostic factors associated with patient’s overall survival (OS). A nomogram based on these prognostic factors was established and internally validated using a bootstrap resampling method.ResultsMultivariate Cox regression analysis revealed the independent prognostic factors for OS were TNM stage, age, lymphocyte-to-monocyte ratio and immunoglobulin G, all of which were identified to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion of the nomogram were lower than those of TNM stage (292.222 vs. 305.480; 298.444 vs. 307.036, respectively), indicating a better goodness-of-fit of the nomogram for predicting OS. The bootstrap-corrected of concordance index (C-index) of nomogram was 0.784 (95% CI 0.708–0.860), which was higher than that of TNM stage (0.685, 95% CI 0.603–0.767, P = 0.017). The results of time-dependent C-index for OS also showed that the nomogram had a better discriminative ability than that of TNM stage. The calibration curves of the nomogram showed good consistency between the probabilities and observed values. The decision curve analysis also revealed the potential clinical usefulness of the nomogram. Based on the cutoff value obtained from the nomogram, the proposed high-risk group had poorer OS than low-risk group (P < 0.0001).ConclusionsThe nomogram based on clinical characteristics and serological inflammation markers might be useful for outcome prediction of OTSCC patient.
Highlights
Oral tongue squamous cell carcinoma (OTSCC) is one of the most prevalent malignancy of the oral cavity worldwide with a relatively poor prognosis [1]
The nomogram based on clinical characteristics and serological inflammation markers might be useful for outcome prediction of OTSCC patient
The optimal cut-off values for the continuous variables were obtained by X-tile as follows: age (69 y), immunoglobulin G (IgG) (12.51 g/L, range 6.06–49.02), immunoglobulin A (IgA) (1.97 g/L, range 0.48–4.58), immunoglobulin M (IgM) (1.09 g/L, range 0.32–3.61), Complement 3 (C3) (1.05 g/L, range 0.42– 2.05), Complement 4 (C4) (0.22 g/L, range 0.097–0.516), B factor (BF) (0.47 g/L, range 0.2–0.92), C-reactive protein (CRP) (3.78 mg/L, range 0.55–69.39), white blood cell count (WBC) (4.95 × 109/L, range 3.1–12.2), lymphocyte-to-monocyte ratio (LMR) (4.15, range 1.36–10.2), neutrophil-to-lymphocyte ratio (NLR) (1.61, range 0.44–7.7) and platelet-tolymphocyte ratio (PLR) (177.86, range 36.98–548.86)
Summary
Oral tongue squamous cell carcinoma (OTSCC) is one of the most prevalent malignancy of the oral cavity worldwide with a relatively poor prognosis [1]. Owing to the diverse clinical pathological characteristics of patients, it is important to predict the outcome of OTSCC patients for the selection of more personalized treatment strategies. Identifying clinically significant and inexpensiveto-measure prognostic factors obtained before surgery would provide more valuable insights to help clinicians and OTSCC patients to choose appropriate treatment strategy. It is necessary to identify a robust prognostic tool that can integrate these potential prognostic factors to complement the TNM staging system to better predict the outcome of OTSCC patients. Oral tongue squamous cell carcinoma (OTSCC) is a prevalent malignant disease that is characterized by high rates of metastasis and postoperative recurrence. The aim of this study was to establish a nomogram to predict the outcome of OTSCC patients after surgery
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