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Observational Study
. 2021 Jan-Dec:20:15330338211043048.
doi: 10.1177/15330338211043048.

A Prognostic Model Based on Clinicopathological Features and Inflammation- and Nutrition-Related Indicators Predicts Overall Survival in Surgical Patients With Tongue Squamous Cell Carcinoma

Lai-Feng Wei  1   2 , Xu-Chun Huang  1   2 , Yi-Wei Lin  1   2 , Yun Luo  1   2 , Tian-Yan Ding  1   2 , Can-Tong Liu  1   2 , Ling-Yu Chu  1   2 , Yi-Wei Xu  1   2 , Yu-Hui Peng  1   2 , Hai-Peng Guo  1
Affiliations
Observational Study

A Prognostic Model Based on Clinicopathological Features and Inflammation- and Nutrition-Related Indicators Predicts Overall Survival in Surgical Patients With Tongue Squamous Cell Carcinoma

Lai-Feng Wei et al. Technol Cancer Res Treat. 2021 Jan-Dec.

Abstract

Objectives: It is reported that inflammation- and nutrition-related indicators have a prognostic impact on multiple cancers. Here we aimed to identify a prognostic nomogram model for prediction of overall survival (OS) in surgical patients with tongue squamous cell carcinoma (TSCC). Methods: The retrospective data of 172 TSCC patients were charted from the Cancer Hospital of Shantou University Medical College between 2008 and 2019. A Cox regression analysis was performed to determine prognostic factors to establish a nomogram and predict OS. The predictive accuracy of the model was analyzed by the calibration curves and the concordance index (C-index). The difference of OS was analyzed by Kaplan-Meier survival analysis. Results: Multivariate analysis showed age, tumor node metastasis (TNM) stage, red blood cell, platelets, and platelet-to-lymphocyte ratio were independent prognostic factors for OS, which were used to build the prognostic nomogram model. The C-index of the model for OS was 0.794 (95% CI = 0.729-0.860), which was higher than that of TNM stage 0.685 (95% CI = 0.605-0.765). In addition, decision curve analysis also showed the nomogram model had improved predictive accuracy and discriminatory performance for OS, compared to the TNM stage. According to the prognostic model risk score, patients in the high-risk subgroup had a lower 5-year OS rate than that in a low-risk subgroup (23% vs 49%, P < .0001). Conclusions: The nomogram model based on clinicopathological features inflammation- and nutrition-related indicators represents a promising tool that might complement the TNM stage in the prognosis of TSCC.

Keywords: clinical features; inflammation; nutrition; prognosis; tongue squamous cell carcinoma.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Forest plot revealed the hazard ratio and 95% confidence interval for OS based on the Cox proportional hazards regression analysis in TSCC patients.
Figure 2.
Figure 2.
Nomogram model based on age, RBC, PLT, PLR, and TNM stage in the prediction of 1-, 3-, and 5-year OS probability in TSCC patients. The total points projected on the bottom scales show the probability of 1-, 3-, and 5-y survival.
Figure 3.
Figure 3.
The calibration plot (a)–(c) are used to estimate OS probability for the nomograms at 1-, 3-, 5-year survival rates.
Figure 4.
Figure 4.
Comparison of predictive accuracy between prognostic model, RBC, PLT, PLR, age, and TNM stage using time-dependent C-index curve analysis.
Figure 5.
Figure 5.
Decision curve analysis the predictive accuracy of model in TSCC patients. The decision curve of 1- (a), 3- (b), and 5- (c) year OS. The y-axis represents the net benefit, which is calculated by summing the benefits (true positive results) and subtracting the harms (false positive results). The horizontal line represents the assumption that no deaths happen.
Figure 6.
Figure 6.
Kaplan–Meier analyses of OS according to the prognostic nomogram model risk score in subgroups of TSCC patients.
See this image and copyright information in PMC

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