Association of Positive Initial Margins With Survival Among Patients With Squamous Cell Carcinoma Treated With Total Laryngectomy

Tassone, Patrick; Savard, Corey; Topf, Michael C.; Keane, William M.; Luginbuhl, Adam; Curry, Joseph; Cognetti, David M.

doi:10.1001/jamaoto.2018.1095

Cited by 27 publications

(23 citation statements)

References 38 publications

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“…Consistent with previous studies, margin status was found to have a significant association with survival among patients with LSCC in the present study [29, 30]. Published trials about LSCC did not report that tumor status was an independent risk factor for OS.…”

Section: Discussionsupporting

confidence: 91%

A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma

et al. 2019

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Background Long noncoding RNAs (lncRNAs), which have little or no ability to encode proteins, have attracted special attention due to their potential role in cancer disease. We aimed to establish a lncRNA signature and a nomogram incorporating the genomic and clinicopathologic factors to improve the accuracy of survival prediction for laryngeal squamous cell carcinoma (LSCC). Methods A LSCC RNA-sequencing (RNA-seq) dataset and the matched clinicopathologic information were downloaded from The Cancer Genome Atlas (TCGA). Using univariable Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, we developed a thirteen-lncRNA signature related to prognosis. On the basis of multivariable Cox regression analysis results, a nomogram integrating the genomic and clinicopathologic predictors was built. The predictive accuracy and discriminative ability of the inclusive nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with the TNM staging system by C-index and receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was conducted to evaluate the clinical value of our nomogram. Results Thirteen overall survival- (OS-) related lncRNAs were identified, and the signature consisting of the selected thirteen lncRNAs could effectively divide patients into high-risk and low-risk subgroups, with area under curves (AUC) of 0.89 (3-year OS) and 0.885 (5-year OS). Independent factors derived from multivariable analysis to predict survival were margin status, tumor status, and lncRNA signature, which were all assembled into the nomogram. The calibration curve for the survival probability showed that the predictions based on the nomogram coincided well with actual observations. The C-index of the nomogram was 0.82 (0.77-0.87), and the area under curve (AUC) of the nomogram in predicting overall survival (OS) was 0.938, both of which were significantly higher than the traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage. Conclusion An inclusive nomogram for patients with LSCC, comprising genomic and clinicopathologic variables, generates more accurate estimations of the survival probability when compared with TNM stage alone, but more data are needed before the nomogram is used in clinical practice.

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Section: Discussionsupporting

confidence: 91%

A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma

et al. 2019

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“…TTTY14 (testis-specific transcript, Y-linked 14) was thought to be associated with human papillomavirus (HPV) induced tumorigenesis, the expression level of TTTY14 was obsearvedly differed between HPV inactive/negative group and HPV active group [28], in accordance with our functional enrichment analysis. In additional, TTTY14 was identified as significantly correlated with overall survival in OSCC and gastric cancer [26,27] Consistent with previous studies, margin status was found to be significant association with survival among patients with LSCC in the present study [29,30]. Published trials about LSCC did not reported that tumor status which was an independent risk factor for OS in our study was related to prognosis of LSCC.…”

Section: Rp11-169k164 and Rp11-107e53 To Predict Recurrence Of Patsupporting

confidence: 90%

A genomic-clinicopathologic nomogram predict survival for patients with laryngeal squamous cell carcinoma

Cui

Wen

Tan

et al. 2019

Preprint

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Long non-coding RNAs (lncRNAs), which have little or no ability to encode proteins, have attracted special attention due to their potential role in cancer disease. We aimed to establish a lncRNAs signature and a nomogram incorporating the genomic and clinicopathologic factors to improve the accuracy of survival prediction for laryngeal squamous cell carcinoma (LSCC). LSCC RNA sequencing (RNA-seq) data set and the matched clinicopathologic information were downloaded from the Cancer Genome Atlas (TCGA). Using univariable Cox regression and Least absolute shrinkage and selection operator (LASSO) analysis, we developed a thirteen lncRNAs signature related to prognosis. On the basis of multivariable Cox regression analysis results, a nomogram integrating the genomic and clinicopathologic predictors was built. The predictive accuracy and discriminative ability of the inclusive nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was conducted to assess clinical value of our nomogram. Consequently, thirteen overall survival (OS) -related lncRNAs were identified, and the signature consisting of the selected thirteen lncRNAs could effectively divide patients into high-risk and low-risk subgroup, with the area under curve (AUC) of 0.89 (3-year OS) and AUC of 0.885(5-year OS). Independent factors derived from multivariable analysis to predict survival were margin status, tumor status and lncRNAs signature, which were all assembled into the nomogram. The calibration curve for the survival probability showed that the predictions based on the nomogram were in good coincide with actual observations. The C-index of the nomogram was 0.82 (0.77-0.87), and the area under curve (AUC) of nomogram in predicting overall survival (OS) was 0.938, which were significantly higher than traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage. In summary, an inclusive nomogram for patients with LSCC, comprising genomic and clinicopathologic variables, generates more accurate estimations of the survival probability when compared TNM stage alone, but more additional data remains needed before being used in clinical practice.

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“…These findings are in agreement with previously published data. 11,13,21,22 A prognostic risk model for early oral tongue SCC may facilitate the prediction of LR and LRR and guide therapeutic choices after glossectomy for patients with pN0 disease. The AJCC decided on a checklist of 16 items necessary for their endorsement of any risk model.…”

Section: Discussionmentioning

confidence: 99%

Early squamous cell carcinoma of the oral tongue with histologically benign lymph nodes: A model predicting local control and vetting of the eighth edition of the American Joint Committee on Cancer pathologic T stage

Sridharan

Thompson

Purgina

et al. 2019

Cancer

Self Cite

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BACKGROUND:The eighth edition of the American Joint Committee on Cancer staging manual (AJCC8) added depth of invasion to the definition of pathologic T stage (pT). In the current study, the authors assess pT stage migration and the prognostic performance of the updated pT stage and compare it with other clinicopathologic variables in patients with early squamous cell carcinoma of the oral tongue (OTSCC; tumors measuring ≤4 cm) with histologically benign lymph nodes (pN0). METHODS: A multi-institutional cohort of patients with early OTSCC was restaged as per AJCC8. Primary endpoints were local recurrence (LR) and locoregional recurrence (LRR). Influential variables were identified and an LR/LRR prediction model was developed. RESULTS: There were a total of 494 patients, with 49 LR and 73 LRR. AJCC8 pT criteria resulted in upstaging of 37.9% of patients (187 of 494 patients), including 34.5% (64 of 185 patients) from pT2 to pT3, without improving the prognostication for LR or LRR. Both LR and LRR were found to be similar for patients with AJCC8 pT2 and pT3 disease. On multivariate analysis, LR was only found to be associated with distance to the closest margin (hazard ratio, 0.36; 95% CI, 0.20-0.64 [P = .0007]) and perineural invasion (hazard ratio, 1.92; 95% CI, 1.10-0.64 [P = .046]). Based on these 2 predictors, a final proportional hazards regression model (which may be used similar to a nomogram) was developed. The proposed model appeared to be superior to AJCC pT stage for estimating the probability of LR and LRR for individual patients with early OTSCC. CONCLUSIONS: AJCC8 pT criteria resulted in pT upstaging of patients with pN0 disease without improved LR or LRR prognostication. The proposed model based on distance to the closest margin and perineural invasion status outperformed pT as a predictor of LR and LRR in patients with early OTSCC. Cancer 2019;125:3198-3207.

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Association of Positive Initial Margins With Survival Among Patients With Squamous Cell Carcinoma Treated With Total Laryngectomy

Cited by 27 publications

References 38 publications

A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma

A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma

A genomic-clinicopathologic nomogram predict survival for patients with laryngeal squamous cell carcinoma

Early squamous cell carcinoma of the oral tongue with histologically benign lymph nodes: A model predicting local control and vetting of the eighth edition of the American Joint Committee on Cancer pathologic T stage

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