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Multicenter Study
. 2025 Mar 20;20(1):42.
doi: 10.1186/s13014-025-02602-1.

Prognostic nomogram for synchronous metastatic nasopharyngeal carcinoma: a retrospective multicentre study

Xiao-Yi Zeng #  1   2 , Ye Li #  1 , Jie Ma #  3 , Zhi-Chao Zuo  4 , Meng-Jie Jiang  1 , Zhong-Guo Liang  1 , Kai-Hua Chen  1 , Ling Li  1   5 , Song Qu  1   5 , Yang Liu  6 , Xiao-Dong Zhu  7   8   9
Affiliations
Multicenter Study

Prognostic nomogram for synchronous metastatic nasopharyngeal carcinoma: a retrospective multicentre study

Xiao-Yi Zeng et al. Radiat Oncol. .

Abstract

Background: Patients with synchronous metastatic nasopharyngeal carcinoma (smNPC) exhibit significant heterogeneity, and clinical prognostic models suitable for this cohort remain limited. We aimed to develop a prognostic prediction tool to facilitate personalised prognostic assessments and inform treatment decisions for these patients.

Methods: This retrospective multicentre study enrolled 556 patients with smNPC. The training cohort comprised 386 patients from Guangxi Medical University Cancer Hospital, while the external validation cohort comprised 170 patients from Wuzhou Red Cross Hospital and Xiangtan Central Hospital. We applied the Cox proportional hazards model to determine factors associated with overall survival (OS). A nomogram prognostic model was developed to predict OS based on the identified prognostic factors. The model's predictive performance was evaluated for discrimination and calibration, and patients were stratified based on their calculated prognostic risk scores. Kaplan-Meier survival curves were employed to assess prognostic differences across the stratified groups.

Results: Multivariate analysis identified that M classification, primary tumour radiotherapy, and immunotherapy were significantly associated with OS. A prognostic nomogram integrating these variables exhibited good discrimination (C-index: 0.743) and calibration, which was validated in an external validation cohort. Patients stratified by the model-derived risk scores into high- and low-risk groups showed a significant difference in survival disparity.

Conclusions: We established a nomogram prognostic model that effectively facilitated individualised prognostic prediction and risk stratification in patients with smNPC, thereby assisting clinicians in treatment decision-making.

Keywords: Multicentre study; Multimodality treatment; Nomogram; Synchronous metastasis nasopharyngeal carcinoma.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This multicentre study was approved by the Institutional Review Boards of Guangxi Medical University Cancer Hospital (GXMUCH), Xiangtan Central Hospital (XTCH), and Wuzhou Red Cross Hospital (WZRCH). Written informed consent was deemed unnecessary due to the study’s retrospective design. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart illustrates patients’ selection. GXMUCH, Guangxi Medical University Cancer Hospital; WZRCH, Wuzhou Red Cross Hospital; XTCH, Xiangtan Central Hospital
Fig. 2
Fig. 2
Prognostic nomogram of survival probabilities at 1-year and 3-year in patients with smNPC
Fig. 3
Fig. 3
Time-dependent ROC of the nomogram model at 1-, and 3-year in the training cohort (A) and validation cohort (B); The calibration curve of the nomogram for predicting OS at 1 and 3 years in the training cohort (C) and validation cohort (D)
Fig. 4
Fig. 4
KM curves for low- and high-risk group patients in the training cohort and external validation cohort
Fig. 5
Fig. 5
Comparison of overall survival between patients with and without LT in the low-risk group of the training cohort (A) and validation cohort (C); Comparison of overall survival between patients with and without LT in the high-risk group of the training cohort (B) and validation cohort (D). LT, local treatment for metastatic lesion
See this image and copyright information in PMC

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