A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients With Hypopharyngeal Squamous Cell Carcinomas: A Population-Based Study

Abstract

Background: Hypopharyngeal squamous cell carcinomas (HPSCC) is one of the causes of death in elderly patients, an accurate prediction of survival can effectively improve the prognosis of patients. However, there is no accurate assessment of the survival prognosis of elderly patients with HPSCC. The purpose of this study is to establish a nomogram to predict the cancer-specific survival (CSS) of elderly patients with HPSCC.Methods: The clinicopathological data of all patients from 2004 to 2018 were downloaded from the SEER database. These patients were randomly divided into a training set (70%) and a validation set (30%). The univariate and multivariate Cox regression analysis confirmed independent risk factors for the prognosis of elderly patients with HPSCC. A new nomogram was constructed to predict 1-, 3-, and 5-year CSS in elderly patients with HPSCC. Then used the consistency index (C-index), the calibration curve, and the area under the receiver operating curve (AUC) to evaluate the accuracy and discrimination of the prediction model. Decision curve analysis (DCA) was used to assess the clinical value of the model.Results: A total of 3,172 patients were included in the study, and they were randomly divided into a training set (N = 2,219) and a validation set (N = 953). Univariate and multivariate analysis suggested that age, T stage, N stage, M stage, tumor size, surgery, radiotherapy, chemotherapy, and marriage were independent risk factors for patient prognosis. These nine variables are included in the nomogram to predict the CSS of patients. The C-index for the training set and validation was 0.713 (95% CI, 0.697–0.729) and 0.703 (95% CI, 0.678–0.729), respectively. The AUC results of the training and validation set indicate that this nomogram has good accuracy. The calibration curve indicates that the observed and predicted values are highly consistent. DCA indicated that the nomogram has a better clinical application value than the traditional TNM staging system.Conclusion: This study identified risk factors for survival in elderly patients with HPSCC. We found that age, T stage, N stage, M stage, tumor size, surgery, radiotherapy, chemotherapy, and marriage are independent prognostic factors. A new nomogram for predicting the CSS of elderly HPSCC patients was established. This model has good clinical application value and can help patients and doctors make clinical decisions.

Development and Validation of a Nomogram to Predict Cancer-Specific Survival in Elderly Patients With Papillary Renal Cell Carcinoma

“…However, only the size of the tumor, the presence of lymph node metastasis, and distant metastasis were used as criteria. Age, marital status, surgical method, chemotherapy and radiotherapy, and other important factors that have been proven to affect cancer patients' overall survival rate (OS) were ignored ( 31 ). Our study found that in elderly patients undergoing pRCC surgery, partial nephrectomy (PN) had the best prognosis, radical nephrectomy (RN) was intermediate, and local tumor resection had the worst prognosis.…”

Updated racial disparities in incidence, clinicopathological features and prognosis of hypopharyngeal squamous carcinoma in the United States

“…Using the SEER database, another study recruited 3,172 HPSCC patients aged 60 and above years old diagnosed from 2004 to 2018. Multivariate survival analysis indicated that there was no significant difference in cancer specific survival between white and black patients [16]. Kuo et al identified a total of 3,357 adult patients with primary HPSCC without distant metastases from the NCDB between 1998 and 2011.…”

“…Several recent studies have built statistical models to predict the prognosis of HPSCC [10][11][12][13][14][15][16]. Race is found to be one of the independent factors correlated with survival in patients with HPSCC in some studies [10][11][12][13], in which black patients were shown to have worse survival compared to whites or other races [10][11][12][13]17].…”

“…Race is found to be one of the independent factors correlated with survival in patients with HPSCC in some studies [10][11][12][13], in which black patients were shown to have worse survival compared to whites or other races [10][11][12][13]17]. (However, other studies reported no racial disparity in the survival of patients with HPSCC [14][15][16]. Clinicopathological features of HPSCC among individual races have not been well investigated.…”