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Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma

BACKGROUND: Lymph node ratio (LNR) has been increasingly reported as a prognostic factor in oral cavity squamous cell carcinoma (OCSCC). This study aimed to develop and validate a prognostic nomogram integrating LNR and to further assess its role in guiding adjuvant therapy for OCSCC. METHODS: A tot...

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Autores principales: Ma, Yuchao, Liu, Yang, Shayan, Gulidanna, Yi, Junlin, Wang, Jingbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Neoplasia Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957048/
https://www.ncbi.nlm.nih.gov/pubmed/35339030
http://dx.doi.org/10.1016/j.tranon.2022.101401
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author Ma, Yuchao
Liu, Yang
Shayan, Gulidanna
Yi, Junlin
Wang, Jingbo
author_facet Ma, Yuchao
Liu, Yang
Shayan, Gulidanna
Yi, Junlin
Wang, Jingbo
author_sort Ma, Yuchao
collection PubMed
description BACKGROUND: Lymph node ratio (LNR) has been increasingly reported as a prognostic factor in oral cavity squamous cell carcinoma (OCSCC). This study aimed to develop and validate a prognostic nomogram integrating LNR and to further assess its role in guiding adjuvant therapy for OCSCC. METHODS: A total of 8703 OCSCC patients treated primarily with surgery in the Surveillance, Epidemiology and End Results (SEER) database were retrieved and randomly divided into training and validation cohorts. The nomogram was created based on the factors identified by Cox model. The value of PORT and chemotherapy was respectively evaluated in each prognostic group according to nomogram-deduced individualized score. RESULTS: The final nomogram included tumor site, grade, T stage, number of positive lymph nodes and LNR. Calibration plots demonstrated a good match between predicted and observed rates of overall survival (OS). The concordance indexes for training and validation cohorts were 0.720 (95% confidence interval (CI): 0.708, 0.732) and 0.711 (95% CI: 0.687, 0.735), both significantly higher than did TNM stage (p< 0.001). According to individualized nomogram score, patients were stratified into three subgroups with significantly distinct outcome. PORT presented survival benefit among medium- and high-risk groups whereas a near-detrimental effect in low-risk group. Chemotherapy was found to be beneficial only in high-risk group. CONCLUSION: This LNR-incorporated nomogram surpassed the conventional TNM stage in predicting prognosis of patients with non-metastatic OCSCC and identified sub-settings that could gain survival benefit from adjuvant thearpy.
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spelling pubmed-89570482022-04-07 Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma Ma, Yuchao Liu, Yang Shayan, Gulidanna Yi, Junlin Wang, Jingbo Transl Oncol Review BACKGROUND: Lymph node ratio (LNR) has been increasingly reported as a prognostic factor in oral cavity squamous cell carcinoma (OCSCC). This study aimed to develop and validate a prognostic nomogram integrating LNR and to further assess its role in guiding adjuvant therapy for OCSCC. METHODS: A total of 8703 OCSCC patients treated primarily with surgery in the Surveillance, Epidemiology and End Results (SEER) database were retrieved and randomly divided into training and validation cohorts. The nomogram was created based on the factors identified by Cox model. The value of PORT and chemotherapy was respectively evaluated in each prognostic group according to nomogram-deduced individualized score. RESULTS: The final nomogram included tumor site, grade, T stage, number of positive lymph nodes and LNR. Calibration plots demonstrated a good match between predicted and observed rates of overall survival (OS). The concordance indexes for training and validation cohorts were 0.720 (95% confidence interval (CI): 0.708, 0.732) and 0.711 (95% CI: 0.687, 0.735), both significantly higher than did TNM stage (p< 0.001). According to individualized nomogram score, patients were stratified into three subgroups with significantly distinct outcome. PORT presented survival benefit among medium- and high-risk groups whereas a near-detrimental effect in low-risk group. Chemotherapy was found to be beneficial only in high-risk group. CONCLUSION: This LNR-incorporated nomogram surpassed the conventional TNM stage in predicting prognosis of patients with non-metastatic OCSCC and identified sub-settings that could gain survival benefit from adjuvant thearpy. Neoplasia Press 2022-03-23 /pmc/articles/PMC8957048/ /pubmed/35339030 http://dx.doi.org/10.1016/j.tranon.2022.101401 Text en © 2022 Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review
Ma, Yuchao
Liu, Yang
Shayan, Gulidanna
Yi, Junlin
Wang, Jingbo
Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title_full Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title_fullStr Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title_full_unstemmed Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title_short Lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
title_sort lymph node ratio-based nomogram for prognosis evaluation and treatment optimization of non-metastatic oral cavity squamous cell carcinoma
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957048/
https://www.ncbi.nlm.nih.gov/pubmed/35339030
http://dx.doi.org/10.1016/j.tranon.2022.101401
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