BACKGROUND: Accurate prognostication is essential to the optimal management of laryngeal cancer. Predictive models have been developed to calculate the risk of oncologic outcomes, but extensive external validation of accuracy and reliability is necessary before implementing them into clinical practice. METHOD: Four published prognostic calculators that predict 5-year overall survival for patients with laryngeal cancer were evaluated using patient information from a prospective epidemiology study cohort (n = 246; median follow-up, 60 months) with previously untreated, stage I through IVb laryngeal squamous cell carcinoma. RESULTS: Different calculators yielded substantially different predictions for individual patients. The observed 5-year overall survival was significantly higher than the averaged predicted 5-year overall survival of the 4 calculators (71.9%; 95% confidence interval [CI], 65%-78%] vs 47.7%). Statistical analyses demonstrated the calculators' limited capacity to discriminate outcomes for risk-stratified patients. The area under the receiver operating characteristic curve ranged from 0.68 to 0.72. C-index values were similar for each of the 4 models (range, 0.66-0.68). There was a lower than expected hazard of death for patients who received induction (bioselective) chemotherapy (hazard ratio, 0.46; 95% CI, 0.24-0.88; P = .024) or primary surgical intervention (hazard ratio, 0.43; 95 % CI, 0.21-0.90; P = .024) compared with those who received concurrent chemoradiation. CONCLUSIONS: Suboptimal reliability and accuracy limit the integration of existing individualized prediction tools into routine clinical decision making. The calculators predicted significantly worse than observed survival among patients who received induction chemotherapy and primary surgery, suggesting a need for updated consideration of modern treatment modalities. Further development of individualized prognostic calculators may improve risk prediction, treatment planning, and counseling for patients with laryngeal cancer. Cancer 2018;124:706-16.
BACKGROUND: Accurate prognostication is essential to the optimal management of laryngeal cancer. Predictive models have been developed to calculate the risk of oncologic outcomes, but extensive external validation of accuracy and reliability is necessary before implementing them into clinical practice. METHOD: Four published prognostic calculators that predict 5-year overall survival for patients with laryngeal cancer were evaluated using patient information from a prospective epidemiology study cohort (n = 246; median follow-up, 60 months) with previously untreated, stage I through IVb laryngeal squamous cell carcinoma. RESULTS: Different calculators yielded substantially different predictions for individual patients. The observed 5-year overall survival was significantly higher than the averaged predicted 5-year overall survival of the 4 calculators (71.9%; 95% confidence interval [CI], 65%-78%] vs 47.7%). Statistical analyses demonstrated the calculators' limited capacity to discriminate outcomes for risk-stratified patients. The area under the receiver operating characteristic curve ranged from 0.68 to 0.72. C-index values were similar for each of the 4 models (range, 0.66-0.68). There was a lower than expected hazard of death for patients who received induction (bioselective) chemotherapy (hazard ratio, 0.46; 95% CI, 0.24-0.88; P = .024) or primary surgical intervention (hazard ratio, 0.43; 95 % CI, 0.21-0.90; P = .024) compared with those who received concurrent chemoradiation. CONCLUSIONS: Suboptimal reliability and accuracy limit the integration of existing individualized prediction tools into routine clinical decision making. The calculators predicted significantly worse than observed survival among patients who received induction chemotherapy and primary surgery, suggesting a need for updated consideration of modern treatment modalities. Further development of individualized prognostic calculators may improve risk prediction, treatment planning, and counseling for patients with laryngeal cancer. Cancer 2018;124:706-16.
Authors: John D Birkmeyer; Andrea E Siewers; Emily V A Finlayson; Therese A Stukel; F Lee Lucas; Ida Batista; H Gilbert Welch; David E Wennberg Journal: N Engl J Med Date: 2002-04-11 Impact factor: 91.245
Authors: Samuel J Wang; Amanda R Wissel; Celine B Ord; Jayashree Kalpathy-Cramer; C David Fuller; John M Holland; Neil D Gross Journal: Otolaryngol Head Neck Surg Date: 2011-07 Impact factor: 3.497
Authors: Ada G T M Egelmeer; E Rios Velazquez; Jos M A de Jong; Cary Oberije; Yasmyne Geussens; Sandra Nuyts; Bernd Kremer; Derek Rietveld; C René Leemans; Monique C de Jong; Coen Rasch; Frank Hoebers; Jarrod Homer; Nick Slevin; Catharine West; Philippe Lambin Journal: Radiother Oncol Date: 2011-07-23 Impact factor: 6.280
Authors: Douglas W Blayney; Kristen McNiff; Peter D Eisenberg; Terry Gilmore; Paul B Jacobsen; Joseph O Jacobson; Pamela J Kadlubek; Michael N Neuss; Joseph Simone Journal: J Clin Oncol Date: 2014-09-15 Impact factor: 44.544
Authors: Borsika A Rabin; Bridget Gaglio; Tristan Sanders; Larissa Nekhlyudov; James W Dearing; Sheana Bull; Russell E Glasgow; Alfred Marcus Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-08-16 Impact factor: 4.254
Authors: Phillip L Ross; Claudia Gerigk; Mithat Gonen; Ofer Yossepowitch; Ilias Cagiannos; Pramod C Sogani; Peter T Scardino; Michael W Kattan Journal: Semin Urol Oncol Date: 2002-05
Authors: Carol R Bradford; Bhavna Kumar; Emily Bellile; Julia Lee; Jeremy Taylor; Nisha D'Silva; Kitrina Cordell; Celina Kleer; Robbi Kupfer; Pawan Kumar; Susan Urba; Francis Worden; Avraham Eisbruch; Gregory T Wolf; Theodoros N Teknos; Mark E P Prince; Douglas B Chepeha; Norman D Hogikyan; Jeffrey S Moyer; Thomas E Carey Journal: Laryngoscope Date: 2013-07-12 Impact factor: 3.325
Authors: Gary S Collins; Joris A de Groot; Susan Dutton; Omar Omar; Milensu Shanyinde; Abdelouahid Tajar; Merryn Voysey; Rose Wharton; Ly-Mee Yu; Karel G Moons; Douglas G Altman Journal: BMC Med Res Methodol Date: 2014-03-19 Impact factor: 4.615
Authors: Jie Cui; Liping Wang; Waisheng Zhong; Zhen Chen; Jie Chen; Hong Yang; Genglong Liu Journal: Cancer Cell Int Date: 2020-09-29 Impact factor: 5.722
Authors: Lauren J Beesley; Peter G Hawkins; Lahin M Amlani; Emily L Bellile; Keith A Casper; Steven B Chinn; Avraham Eisbruch; Michelle L Mierzwa; Matthew E Spector; Gregory T Wolf; Andrew G Shuman; Jeremy M G Taylor Journal: Cancer Date: 2018-10-06 Impact factor: 6.860
Authors: Lauren J Beesley; Andrew G Shuman; Michelle L Mierzwa; Emily L Bellile; Benjamin S Rosen; Keith A Casper; Mohannad Ibrahim; Sarah M Dermody; Gregory T Wolf; Steven B Chinn; Matthew E Spector; Robert J Baatenburg de Jong; Emilie A C Dronkers; Jeremy M G Taylor Journal: JAMA Netw Open Date: 2021-08-02