Saurabh Bobdey1, Manish Mair2, Sudhir Nair2, Deepa Nair2, Ganesh Balasubramaniam3, Pankaj Chaturvedi2. 1. Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, India. Electronic address: sbobdey@yahoo.com. 2. Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai. 3. Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, India.
Abstract
BACKGROUND AND OBJECTIVES: T4 squamous cell carcinomas of the buccal mucosa is known to have ominous outcome. The aim of this study was to develop a nomogram for T4 buccal mucosa cancer patients and demonstrate the difference in survival based on prognosticators beyond those covered by the traditional TNM staging system. METHODS: We examined medical records of treatment naïve 205 T4 buccal mucosa cancer patients operated between January 1, 2009, and December 31, 2014. A nomogram was developed using multivariate cox-regression. The nomogram was validated internally by bootstrapping and externally in an independent validation set. RESULTS: The nomogram for predicting 3-year overall survival was built using Tumor differentiation, Pathological Lymph node involvement, Bone and Perineural invasion. Based on nomogram, a score was assigned to each patient and they were divided into two groups based on Youden derived cut-off value (13.5). These two groups in training and validation set showed significant difference in survival. CONCLUSION: We developed a high performance, accurate and efficient nomogram to predict the probability of 3-year survival in T4 buccal mucosa cancer patients. Intensification of adjuvant treatment in these advanced cancer patients with poorer score might improve their survival.
BACKGROUND AND OBJECTIVES: T4 squamous cell carcinomas of the buccal mucosa is known to have ominous outcome. The aim of this study was to develop a nomogram for T4 buccal mucosa cancerpatients and demonstrate the difference in survival based on prognosticators beyond those covered by the traditional TNM staging system. METHODS: We examined medical records of treatment naïve 205 T4 buccal mucosa cancerpatients operated between January 1, 2009, and December 31, 2014. A nomogram was developed using multivariate cox-regression. The nomogram was validated internally by bootstrapping and externally in an independent validation set. RESULTS: The nomogram for predicting 3-year overall survival was built using Tumor differentiation, Pathological Lymph node involvement, Bone and Perineural invasion. Based on nomogram, a score was assigned to each patient and they were divided into two groups based on Youden derived cut-off value (13.5). These two groups in training and validation set showed significant difference in survival. CONCLUSION: We developed a high performance, accurate and efficient nomogram to predict the probability of 3-year survival in T4 buccal mucosa cancerpatients. Intensification of adjuvant treatment in these advanced cancerpatients with poorer score might improve their survival.