Background:
The incidence of nonkeratinizing large cell squamous cell carcinoma (NKLCSCC) continues to rise. Compared to other squamous cell carcinoma subtypes, the NKLCSCC displays lower differentiation and higher malignancy, necessitating specialized analysis and research of this disease. Therefore, the aim of our study was to develop and evaluate a novel conditional survival (CS)-based prediction model for NKLCSCC patients, with the objective of offering timely and accurate updates on survival rates.
Methods:
The data for patients with NKLCSCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The identified patients were randomized into the training group and the validation group, with a proportion of 7:3. The Kaplan–Meier method was used to estimate overall survival (OS). The CS rate was defined as the likelihood of a patient surviving for a specific period of time following NKLCSCC diagnosis, based on the number of years they have already survived. We firstly described the CS pattern of the NKLCSCC patients. Subsequently, a least absolute shrinkage and selection operator (LASSO) regression method with 10-fold cross-validation was employed to identify prognostic factors. A multivariate Cox regression model was used to demonstrate these predictors’ prognostic value and to develop a CS-based nomogram model. Lastly, the predictive performance of the developed model was evaluated and validated.
Results:
Based on the SEER database, a total of 7,252 elderly patients with NKLCSCC were identified from 2000 to 2019, with 5,076 patients allocated to the training group and 2,176 patients assigned to the validation group. Through CS analysis, we observed that these patients exhibited a remarkable improvement in 10-year survival rate with each additional year of survival. The survival rate increased from initially 56% to 62%, 70%, 74%, 79%, 82%, 86%, 90%, 93% and ultimately reached an impressive 97%. The LASSO regression analysis achieved a 10-fold cross-validation and identified 9 significant predictive factors. Then, the CS-based nomogram was successfully constructed based on these selected predictors and it could effectively stratify risk for these patients. Furthermore, this CS-based survival prediction model was successfully validated in both training and validation groups.
Conclusion:
This study described the CS pattern of patients with NKLCSCC, underscoring the gradual improvement in survival rates among long-term survivors over time. We have also developed the first novel CS-based nomogram model for NKLCSCC patients, which enables real-time prognostic prediction and risk stratification, facilitating personalized treatment decision-making and devising more cost-effective follow-up strategies for clinicians.