Luo XY, Zhang YM, Zhu RQ, Yang SS, Zhou LF, Zhu HY. Development and validation of novel nomograms to predict survival of patients with tongue squamous cell carcinoma. World J Clin Cases 2022; 10(32): 11726-11742 [PMID: 36405263 DOI: 10.12998/wjcc.v10.i32.11726]
Corresponding Author of This Article
Hui-Yong Zhu, MD, PhD, Professor, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. zhuhuiyong@zju.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xia-Yan Luo, Ya-Min Zhang, Run-Qiu Zhu, Hui-Yong Zhu, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Shan-Shan Yang, Department of Stomatology, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
Lu-Fang Zhou, Department of Stomatology, Jiangshan People's Hospital, Quzhou 324199, Zhejiang Province, China
Author contributions: Luo XY and Zhang YM contributed equally to this work and share the first authorship; Luo XY, Zhang YM, and Zhu HY designed the research study; Zhu RQ, Yang SS, and Zhou LF collected data; Luo XY and Zhang YM analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Approval No. IIT20210346A).
Informed consent statement: The informed consent was exempted.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest.
Data sharing statement: The datasets of this study are available on request to the corresponding author.
STROBE statement: All the authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Yong Zhu, MD, PhD, Professor, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. zhuhuiyong@zju.edu.cn
Received: August 8, 2022 Peer-review started: August 8, 2022 First decision: September 25, 2022 Revised: October 2, 2022 Accepted: October 17, 2022 Article in press: October 17, 2022 Published online: November 16, 2022 Processing time: 91 Days and 22.9 Hours
Abstract
BACKGROUND
There is no unified standard to predict postoperative survival in patients with tongue squamous cell carcinoma (TSCC), hence the urgency to develop a model to accurately predict the prognosis of these patients.
AIM
To develop and validate nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) of patients with TSCC.
METHODS
A cohort of 3454 patients with TSCC from the Surveillance, Epidemiology, and End Results (SEER) database was used to develop nomograms; another independent cohort of 203 patients with TSCC from the Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhejiang University School of Medicine, was used for external validation. Univariate and multivariate analyses were performed to identify useful variables for the development of nomograms. The calibration curve, area under the receiver operating characteristic curve (AUC) analysis, concordance index (C-index), net reclassification index (NRI), and decision curve analysis (DCA) were used to assess the calibration, discrimination ability, and clinical utility of the nomograms.
RESULTS
Eight variables were selected and used to develop nomograms for patients with TSCC. The C-index (0.741 and 0.757 for OS and CSS in the training cohort and 0.800 and 0.830 in the validation cohort, respectively) and AUC indicated that the discrimination abilities of these nomograms were acceptable. The calibration curves of OS and CSS indicated that the predicted and actual values were consistent in both the training and validation cohorts. The NRI values (training cohort: 0.493 and 0.482 for 3- and 5-year OS and 0.424 and 0.402 for 3- and 5-year CSS; validation cohort: 0.635 and 0.750 for 3- and 5-year OS and 0.354 and 0.608 for 3- and 5-year CSS, respectively) and DCA results indicated that the nomograms were significantly better than the tumor-node-metastasis staging system in predicting the prognosis of patients with TSCC.
CONCLUSION
Our nomograms can accurately predict patient prognoses and assist clinicians in improving decision-making concerning patients with TSCC in clinical practice.
Core Tip: In order to predict prognosis more accurately and precisely, we used two cohorts to develop nomograms in predicting overall survival and cancer-specific survival of patients with tongue squamous cell carcinoma. We adhered to the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis statement-not only evaluated these nomograms in discrimination, calibration, but also their clinical utility. Additionally, the net reclassification index was also used to assess the accuracy of them. These nomograms provide patients and clinicians with an accurate prognosis, so as to facilitate patient-clinician communications and assist clinicians in improving decision-making.
