Nomograms for predicting long-term overall survival and cancer-specific survival in patients with major salivary gland cancer: a population-based study

Abstract

In this study, we aimed to develop and validate nomograms for predicting long-term overall survival (OS) and cancer-specific survival (CSS) in major salivary gland cancer (MSGC) patients. These nomograms were developed using a retrospective cohort (N=4218) from the Surveillance, Epidemiology, and End Results (SEER) database, and externally validated using an independent data cohort (N=244). We used univariate, and multivariate analyses, and cumulative incidence function to select the independent prognostic factors of OS and CSS. Index of concordance (c-index) and calibration plots were used to estimate the nomograms’ predictive accuracy. The median follow-up period was 34 months (1–119 months). Of 4218 MSGC patients, 1320 (31.3%) died by the end of the follow-up; of these 1320 patients, 883 (20.9%) died of MSGC. The OS nomogram, which had a c-index of 0.817, was based on nine variables: age, sex, tumor site, tumor grade, surgery performed, radiation therapy and TNM classifications. The CSS nomogram, which had a c-index of 0.829, was based on the same nine variables plus race. External validation c-indexes were 0.829 and 0.807 for OS and CSS, respectively. Based on SEER database, we have developed nomograms predicting five- and eight-years OS and CSS for MSGC patients with perfect accuracy. These nomograms will help clinicians customize treatment and monitoring strategies in MSGC patients.

Prognostic nomogram for disease‐specific survival of carcinoma ex pleomorphic adenoma of the salivary gland

“…To ensure the predictive accuracy of our nomogram, C‐indexes and calibration plots were applied to estimate the predictive accuracy of the models by performing internal validation. Our nomogram performed excellently in predicting DSS of Ca‐ex‐PA, and its prediction was supported by the C‐index (0.90 and 0.86 for the primary and validation cohorts, respectively) and the calibration curve, which compared very favorably with those of other widely accepted nomograms in other cancers, whose C‐indexes ranged from 0.60‐0.80. When compared with the TNM classification system (0.75 and 0.77 for the primary and validation cohorts, respectively), our nomogram also showed better predictive accuracy for survival.…”

Develop and validation a nomogram to predict the recurrent probability in patients with major salivary gland cancer

“…In Table 4 , we summarized and compared known nomograms in prediction outcome for patients with MSGC from retrospective studies 7 , 27 , 28 . All the nomograms were developed based on combination of patient's clinical factor (age, sex, and smoking history) and pathologic characteristics of tumor (T-N-M classification, tumor grade, lymphatic invasion, perineural invasion, tumor dimension, and tumor site) with a similar performance in regard of concordance index.…”

“…Ali S. et al developed two nomograms in prediction tumor recurrence and overall survival, respectively, based on 301 patient cohorts from the MSKCC in the United States 7 , 27 , however, the models were lack of external validation. Li Y. et al developed the nomogram in prediction of overall and cancer-specific survival based on 4218 patients from SEER database 28 , the model was externally validated from an independent patient cohort in China. As the retrospective analysis of SEER database, the author incorporated treatment modalities including surgery and radiotherapy into the model, the model might have selection biased because some patients were medical unfit for those treatment.…”

“…Age negatively impacts survival of patients with MSGC in several studies 27 , 28 . Contrary, Ali S. et al reported age as a good prognostic factor 7 .…”

Personalized prognostication in head and neck cancer: A systematic review of nomograms according to the AJCC precision medicine core (PMC) criteria

“…The level of agreement for the second phase was 88% with a kappa of 0.77. A total of 44 studies remained for the final analysis . The list of excluded papers with the reasons for exclusion can be found in the Supporting Information S3.…”