Development and validation of novel nomograms to predict survival of patients with tongue squamous cell carcinoma

Xia-Yan Luo; Ya-Min Zhang; Run-Qiu Zhu; Shan-Shan Yang; Lu-Fang Zhou; Hui-Yong Zhu

doi:10.12998/wjcc.v10.i32.11726

Development and validation of novel nomograms to predict survival of patients with tongue squamous cell carcinoma

World J Clin Cases. 2022 Nov 16;10(32):11726-11742. doi: 10.12998/wjcc.v10.i32.11726.

Authors

Xia-Yan Luo¹, Ya-Min Zhang¹, Run-Qiu Zhu¹, Shan-Shan Yang², Lu-Fang Zhou³, Hui-Yong Zhu⁴

Affiliations

¹ Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
² Department of Stomatology, Sanmen People's Hospital, Taizhou 317100, Zhejiang Province, China.
³ Department of Stomatology, Jiangshan People's Hospital, Quzhou 324199, Zhejiang Province, China.
⁴ Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China. zhuhuiyong@zju.edu.cn.

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.

Keywords: Cancer-specific survival; Nomogram; Overall survival; Prognosis; Tongue squamous cell carcinoma.