Three prognostic indexes as predictors of response to adjuvant chemoradiotherapy in patients with oral squamous cell carcinoma after radical surgery: A large‐scale prospective study

Abstract

Background To develop and validate practical prognostic indexes (PIs) for predicting the prognosis and response to postoperative adjuvant therapy in patients with oral squamous cell carcinoma (OSCC). Methods A large cohort of 1071 OSCC patients were randomized to either training set (N = 708) or validation set (N = 363). Three types of PIs were developed according to the nomogram scores, β coefficients and excess hazard ratios, respectively. Restricted cubic spline was used to demonstrate the relationship between PIs and the risks of death. Results First, a nomogram was developed incorporating age at diagnosis, smoking status, clinical stage, tumor differentiation, lymph node status, comorbidity, and neutrophil to lymphocyte ratio levels. Then, three PIs were established with high survival predictive ability, and were superior to AJCC staging system (all P < .05). The risks of death were escalated continuously with the increasing number of PIs. Interestingly, adjuvant chemoradiotherapy was positively associated with poor overall survival in patients with low PIs, but exerted a beneficial effect on patients with high PIs. Conclusion Combined nomogram with further established PIs not only predicts the survival probability of OSCC patients, but also continuously quantifies the risk of death. High PIs could predict a beneficial response to adjuvant chemoradiotherapy, whereas low PIs indicate an unfavorable response.

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

“…Chemotherapy is an important treatment for oral cancer patients. However, several previous studies found that chemotherapy was not associated with improved prognosis of oral cancer [31]. Hence, whether all patients should be recommended for chemotherapy is still controversial.…”

Predictive nomograms for oral tongue squamous cell carcinoma applying the American Joint Committee on Cancer/Union Internationale Contre le Cancer 8th edition staging system

“…Although several nomograms have been described for oral SCC, [21][22][23][24][25][26] attempts at devising a nomogram for OTSCC alone have been limited. Li and colleagues used data from the SEER database on 12 674 patients to design such a nomogram including the variables age, race, marital status, TNM stage and tumor grading.…”

Prognostic value of preoperative systemic inflammation response index in patients with oral squamous cell carcinoma: Propensity score‐based analysis

“…A growing body of evidence obtained from epidemiological studies has shown that systemic inflammatory markers based on circulating blood cell, such as the neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and platelet‐to‐lymphocyte ratio (PLR), were related to the survival outcome of patients with OSCC 5‐7 . Meanwhile, compared with the traditional AJCC staging system, the nomogram combined with biomarkers of systemic inflammatory response could predict the prognosis of OSCC more accurately 8‐10 …”