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Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma

The TNM staging system of NPC is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. This study aimed to develop a nomogram for predicting the overall survival of loco-regionally advanced nasopharyngeal carcinoma. 48...

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Autores principales: Jiang, Yanming, Qu, Song, Pan, Xinbin, Huang, Shiting, Zhu, Xiaodong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6972859/
https://www.ncbi.nlm.nih.gov/pubmed/31965045
http://dx.doi.org/10.1038/s41598-020-57968-x
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author Jiang, Yanming
Qu, Song
Pan, Xinbin
Huang, Shiting
Zhu, Xiaodong
author_facet Jiang, Yanming
Qu, Song
Pan, Xinbin
Huang, Shiting
Zhu, Xiaodong
author_sort Jiang, Yanming
collection PubMed
description The TNM staging system of NPC is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. This study aimed to develop a nomogram for predicting the overall survival of loco-regionally advanced nasopharyngeal carcinoma. 487 Patients with confimed nasopharyngeal carcinoma who underwent IMRT and chemotherapy were included in this study. We established prognostic nomogram for overall survival (OS) based on the Cox proportional hazards model. The predictive accuracy and discriminative ability were measured using the concordance index (C-index) and calibration curve. Nomogram was validated externally by assessing discrimination and calibration using an independent data set. Continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to analyze whether nomogram improve the prediction of survival than TNM stage system. Recursive partitioning analysis (RPA) was performed to stratifying risk of patients. Age, T-stage, N-stage, NLR, LDH were included in the nomogram for OS. The C-index of the nomogram for OS were 0.726 (95% CI, 0.690 to 0.762); The calibration curve showed the nomogram was able to predict 5-year OS accurately. The nomogram had a higher C-index than the TNM stage system (0.726 VS 0.632, P-value < 0.001). The NRI was 0.235 (95% CI: 0.129 to 0.396, P < 0.001), the IDI was 0.079 (95% CI: 0.034 to 0.396, p < 0.001). RPA was performed to stratify patients into three risk group, OS was significantly different between all three risk groups. High risk groups can be benefited survival from adjuvant chemotherapy. The nomogram outperformed the TNM staging system in predicting the OS of loco-regionally advanced nasopharyngeal carcinoma underwent intensity modulated radiation therapy and chemotherapy.
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spelling pubmed-69728592020-01-27 Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma Jiang, Yanming Qu, Song Pan, Xinbin Huang, Shiting Zhu, Xiaodong Sci Rep Article The TNM staging system of NPC is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. This study aimed to develop a nomogram for predicting the overall survival of loco-regionally advanced nasopharyngeal carcinoma. 487 Patients with confimed nasopharyngeal carcinoma who underwent IMRT and chemotherapy were included in this study. We established prognostic nomogram for overall survival (OS) based on the Cox proportional hazards model. The predictive accuracy and discriminative ability were measured using the concordance index (C-index) and calibration curve. Nomogram was validated externally by assessing discrimination and calibration using an independent data set. Continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to analyze whether nomogram improve the prediction of survival than TNM stage system. Recursive partitioning analysis (RPA) was performed to stratifying risk of patients. Age, T-stage, N-stage, NLR, LDH were included in the nomogram for OS. The C-index of the nomogram for OS were 0.726 (95% CI, 0.690 to 0.762); The calibration curve showed the nomogram was able to predict 5-year OS accurately. The nomogram had a higher C-index than the TNM stage system (0.726 VS 0.632, P-value < 0.001). The NRI was 0.235 (95% CI: 0.129 to 0.396, P < 0.001), the IDI was 0.079 (95% CI: 0.034 to 0.396, p < 0.001). RPA was performed to stratify patients into three risk group, OS was significantly different between all three risk groups. High risk groups can be benefited survival from adjuvant chemotherapy. The nomogram outperformed the TNM staging system in predicting the OS of loco-regionally advanced nasopharyngeal carcinoma underwent intensity modulated radiation therapy and chemotherapy. Nature Publishing Group UK 2020-01-21 /pmc/articles/PMC6972859/ /pubmed/31965045 http://dx.doi.org/10.1038/s41598-020-57968-x Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Jiang, Yanming
Qu, Song
Pan, Xinbin
Huang, Shiting
Zhu, Xiaodong
Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title_full Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title_fullStr Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title_full_unstemmed Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title_short Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma
title_sort prognostic nomogram for locoregionally advanced nasopharyngeal carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6972859/
https://www.ncbi.nlm.nih.gov/pubmed/31965045
http://dx.doi.org/10.1038/s41598-020-57968-x
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