Nomograms to predict the prognosis in locally advanced oral squamous cell carcinoma after curative resection

Abstract

Background Oral squamous cell carcinoma (OSCC) is the dominant histologic type of oral cancer. Locally advanced OSCC remains a major therapeutic challenge. Our study aimed to develop and validate nomograms predicting survival prognosis in patients with locally advanced oral squamous cell carcinoma (OSCC) after curative resection. Methods A total of 269 consecutive patients with primary OSCC who received curative resection between September 2007 and March 2020 were retrospectively enrolled in our study. Patients were randomly assigned to the training cohort (n = 201) or the validation cohort (n = 68). Multivariate Cox regression analyses were conducted to determine independent prognostic factors for overall survival (OS) and cancer specific survival (CSS) in the training set, which were used to develop nomogram models estimating 3-, and 5-year OS and CSS. We also evaluated the nomograms using concordance indices (c-index), calibration curves, and decision curve analyses (DCA), and compared those with the AJCC 8th staging system. The results were externally validated in the validation cohort. Results Age, Kaplan-Feinstein (KFI) index, pT, the number of positive nodes and systemic inflammatory index (SII) were significant prognostic predictors for OS and CSS. The OS nomogram had c-index values of 0.712 in the training set and 0.697 in the validation set, while the CSS nomogram exhibited c-index values of 0.709 in the training set and 0.675 in the validation set. These data were superior to those of AJCC 8th staging system, suggesting high discriminative ability of the nomograms. Calibration curves exhibited good agreement between observed and predicted survival. DCA curves indicated the nomograms were with potential clinical usefulness. These results were validated in the validation set. Conclusions The novel nomograms incorporating clinically available characteristics for OS and CSS prediction were developed in the locally advanced OSCC patients after curative surgery. Validation revealed good discrimination and calibration, indicating the clinical utility of the nomograms in the individualized prognosis prediction of locally advanced OSCC after curative surgery.

Prognostic Role of Systemic Inflammatory Markers in Patients Undergoing Surgical Resection for Oral Squamous Cell Carcinoma

“…They are derived from three types of inflammatory cells (lymphocytes, neutrophils, and platelets or monocytes), and were shown to be independent predictors of overall survival in patients with lung [ 24 , 27 ], breast [ 26 ], esophageal [ 25 ], and urologic cancers [ 28 ]. High preoperative SII and SIRI were also shown to be independent prognostic factors in patients with OSCC, but the data are still very limited [ 29 , 30 , 31 , 32 ].…”

A nomogram to predict stricture after endoscopic submucosal dissection for early esophageal cancer

“…Nomograms as estimators have shown promising potential in clinical trial design and interpretation and have been widely adopted in prognostic models [14][15][16]. To our knowledge, this is the rst study providing a nomogram to predict postoperative stricture risk.…”

Development and validation of the nomogram based on INR and eGFR for estimation of mortality in patients with acute-on-chronic hepatitis B liver failure

“…A cohort of ACHBLF patients who had been hospitalized in Tianjin Second People’s Hospital between January 2015 and December 2020 was enrolled. We developed a prognostic nomogram based on the above cohort, which was randomly assigned to derivation cohort (n = 75) and validation cohort (n = 35) according to 7:3 as described in previous studies [ 8 ]. Nomogram discrimination was assessed by concordance index (C-index), and calibration was conducted with calibration curve and Hosmer–Lemeshow test.…”

“…In recent years, a variety of prognostic indices and models have been established with technological improvements in the field of molecular biology, genomics and transcriptomics, such as Neutrophil–lymphocyte ratio (NLR) [ 6 ], Th17/Treg [ 7 ], nomogram [ 8 ] and so on. Among them, nomogram has been proved to provide an individualized and highly accurate risk assessment [ 9 , 10 ].…”