Development and validation of a prognostic nomogram for the pre-treatment prediction of early metachronous metastasis in endemic nasopharyngeal carcinoma: a big-data intelligence platform-based analysis
| Autor: | Ting Wang, Meng-Yao Huang, Jian Yong Shao, Di Song, Yong-Shi Huang, Yi-Yang Li, Lu-Lu Zhang, Wenting He, Fei Xu, Qi-Ling Deng |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Pre treatment medicine.medical_specialty Poor prognosis risk stratification lcsh:RC254-282 nomogram 03 medical and health sciences 0302 clinical medicine Metachronous metastasis Internal medicine medicine Early failure Original Research business.industry nasopharyngeal carcinoma Nomogram medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cancer treatment 030104 developmental biology Nasopharyngeal carcinoma 030220 oncology & carcinogenesis Risk stratification prognosis business early metachronous metastasis |
| Zdroj: | Therapeutic Advances in Medical Oncology, Vol 12 (2020) Therapeutic Advances in Medical Oncology |
| ISSN: | 1758-8359 |
| Popis: | Background: Early failure of cancer treatment generally indicates a poor prognosis. Here, we aim to develop and validate a pre-treatment nomogram to predict early metachronous metastasis (EMM) in nasopharyngeal carcinoma (NPC). Methods: From 2009 to 2015, a total of 9461 patients with NPC (training cohort: n = 7096; validation cohort: n = 2365) were identified from an institutional big-data research platform. EMM was defined as time to metastasis within 2 years after treatment. Early metachronous distant metastasis-free survival (EM-DMFS) was the primary endpoint. A nomogram was established with the significant prognostic factors for EM-DMFS determined by multivariate Cox regression analyses in the training cohort. The Harrell Concordance Index (C-index), area under the receiver operator characteristic curve (AUC), and calibration curves were applied to evaluate this model. Results: EMM account for 73.5% of the total metachronous metastasis rate and is associated with poor long-term survival in NPC. The final nomogram, which included six clinical variables, achieved satisfactory discriminative performance and significantly outperformed the traditional tumor–node–metastasis (TNM) classification for predicting EM-DMFS: C-index: 0.721 versus 0.638, p Conclusion: Our established nomogram can reliably predict EMM in patients with NPC and might aid in formulating risk-adapted treatment decisions and personalized patient follow-up strategies. |
| Databáze: | OpenAIRE |
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