Development and validation of a nomogram for predicting the survival of patients with non-metastatic nasopharyngeal carcinoma after curative treatment

Abstract

BackgroundThe TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopathologic factors for predicting the overall survival (OS) of non-metastatic nasopharyngeal carcinoma (NPC) patients after curative treatments.MethodsWe retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity-modulated radiation therapy (IMRT) between 2001 and 2010 were also retrieved to examine the extensibility of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index (c-index).ResultsWe identified and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c-index of the nomogram was statistically higher than that of the 7th edition TNM staging system for predicting the survival in both the primary cohort (0.69 vs. 0.62) and the IMRT cohort (0.67 vs. 0.63).ConclusionWe developed and validated a novel nomogram that outperformed the TNM staging system in predicting the OS of non-metastatic NPC patients who underwent curative therapy.

A Pairwise Meta-Analysis of Induction Chemotherapy in Nasopharyngeal Carcinoma

“…In the real‐world clinical practice, however, the efficacy of induction chemotherapy was minimal, as observed in different populations . Perhaps a more precise selection of real high‐risk patients based on prognostic tools (e.g., tumor volume , Epstein‐Barr virus deoxyribonucleic acid , or nomogram ) and application of new chemotherapy regimens might be the promising strategies for induction chemotherapy in the future.…”

Combined prognostic value of pretreatment anemia and cervical node necrosis in patients with nasopharyngeal carcinoma receiving intensity‐modulated radiotherapy: A large‐scale retrospective study

“…The tumor‐node‐metastasis (TNM) staging system for NPC is the most powerful tool for guiding the selection of treatment strategies and predicting the prognosis of patients with NPC . Although application of superior RT technique intensity‐modulated radiation therapy (IMRT) and addition of chemotherapy and the precise imaging technology magnetic resonance imaging (MRI) have improved locoregional control, the survival outcomes among patients with advanced NPC remain unsatisfactory . Therefore, the identification of clinically relevant prognostic factors to recognize patients at high‐risk of failure is necessary.…”

A novel prognostic model predicts overall survival in patients with nasopharyngeal carcinoma based on clinical features and blood biomarkers

“…3. Many previous models usual integrated with TNM staging and/or clinical treatment to improve the predictive accuracy for clinical outcome [27,[40][41][42][43][44][45], which made them not applicable to the patients with uncertain clinical TNM staging. This model can be used for patients with TNM staging remained unclear because of it was not include TNM staging.…”