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. 2021 Aug;43(8):2445-2456.
doi: 10.1002/hed.26716. Epub 2021 May 7.

Predicting survival in head and neck cancer: External validation and update of the prognostic model OncologIQ in 2189 patients

Arta Hoesseini  1 , Nikki van Leeuwen  2 , Marinella P J Offerman  1 , Jang Zhang  1 , Emilie A C Dronkers  1 , Aniel Sewnaik  1 , Hester F Lingsma  2 , Robert Jan Baatenburg de Jong  1
Affiliations

Predicting survival in head and neck cancer: External validation and update of the prognostic model OncologIQ in 2189 patients

Arta Hoesseini et al. Head Neck. 2021 Aug.

Abstract

Background: Disclosing prognostic information is necessary to enable patients to make well-informed treatment decisions. OncologIQ is a prognostic model that predicts the overall survival (OS) probability in patients with head and neck squamous cell carcinoma (HNSCC). We aimed to externally validate and update the model with new prognostic factors and translate it to a clinically useful tool.

Methods: A consecutive retrospective sample of 2189 patients eligible for curative treatment of a primary HNSCC were selected. Discriminative performance was determined using the C-statistic.

Results: External validation showed systematic underestimation of OS in the new population, and reasonable discrimination (C-statistic 0.67). Adding smoking, pack years, BMI, weight loss, WHO performance, socioeconomic status, and p16 positivity to the recalibrated multivariable model, improved the internally validated C-statistic to 0.71. The model showed minor optimism and was translated in an online tool (www.oncologiq.nl).

Conclusions: The updated model enables personalized patient counseling during treatment decision consultations.

Keywords: head and neck cancer; prediction; prognosis; shared decision making; survival.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

FIGURE 1
FIGURE 1
Calibration plots: predicted probabilities and observed frequencies in five quintiles at 5 and 10 years after diagnosis. (A) 5‐year survival probability. (B) 10‐year survival probability
FIGURE 2
FIGURE 2
The difference in survival probabilities for individual patients in the original and the updated model, at (A) 5 years and (B) 10 years. (A) 5‐year survival probability. (B) 10‐year survival probability. Each dot represents an individual patient. On the x‐axis the predicted survival probabilities of the updated model are shown, on the y‐axis the predicted survival probabilities of the original model are shown. For most patients, both predicted probabilities are similar. However, on an individual level, the updated model shows reasonably different estimations, compared to the original model. This indicates the added value of the updated model at an individual level. The maximal difference in individually estimated probabilities ranged from −0.51 to 0.54 for 5‐year survival, and −0.53 to 0.49 for 10‐year survival [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Screenshot of the updated model www.oncologiq.nl [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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