OBJECTIVE: This study focused on developing an effective nomogram for improving prognostication for patients with primary nasopharyngeal carcinoma (NPC) restaged according to the eighth edition of the AJCC/UICC TNM staging system. METHODS: Based on data of 5,903 patients with non-metastatic NPC (primary cohort), we used Cox regression analysis to identify survival risk factors and created a nomogram. We used the nomogram to predict overall survival (OS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) in the primary and independent validation (3,437 patients) cohorts. Moreover, we compared the prognostic accuracy between the 8th TNM system and the nomogram. RESULTS: The nomogram included gender, age, T stage, N stage, Epstein-Barr virus DNA, hemoglobin, C-reactive protein, lactate dehydrogenase, and radiotherapy with/without induction or concurrent chemotherapy. In the prediction of OS, DMFS and DFS, the nomogram had significantly higher concordance index (C-index) and area under ROC curve (AUC) than the TNM system alone. Calibration curves demonstrated satisfactory agreements between nomogram-predicted and observed survival. The stratification in different groups permitted remarkable differentiation among Kaplan-Meier curves for OS, DMFS, and DFS. CONCLUSION: The nomogram led to a more precise prognostic prediction for NPC patients in comparison with the 8th TNM system. Therefore, it could facilitate individualized and personalized patients' counseling and care.
OBJECTIVE: This study focused on developing an effective nomogram for improving prognostication for patients with primary nasopharyngeal carcinoma (NPC) restaged according to the eighth edition of the AJCC/UICC TNM staging system. METHODS: Based on data of 5,903 patients with non-metastatic NPC (primary cohort), we used Cox regression analysis to identify survival risk factors and created a nomogram. We used the nomogram to predict overall survival (OS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) in the primary and independent validation (3,437 patients) cohorts. Moreover, we compared the prognostic accuracy between the 8th TNM system and the nomogram. RESULTS: The nomogram included gender, age, T stage, N stage, Epstein-Barr virus DNA, hemoglobin, C-reactive protein, lactate dehydrogenase, and radiotherapy with/without induction or concurrent chemotherapy. In the prediction of OS, DMFS and DFS, the nomogram had significantly higher concordance index (C-index) and area under ROC curve (AUC) than the TNM system alone. Calibration curves demonstrated satisfactory agreements between nomogram-predicted and observed survival. The stratification in different groups permitted remarkable differentiation among Kaplan-Meier curves for OS, DMFS, and DFS. CONCLUSION: The nomogram led to a more precise prognostic prediction for NPC patients in comparison with the 8th TNM system. Therefore, it could facilitate individualized and personalized patients' counseling and care.
Authors: Anthony T C Chan; S F Leung; Roger K C Ngan; Peter M L Teo; W H Lau; W H Kwan; Edwin P Hui; H Y Yiu; Winnie Yeo; F Y Cheung; K H Yu; K W Chiu; D T Chan; Tony S K Mok; Stephen Yau; K T Yuen; Frankie K F Mo; Maria M P Lai; Brigette B Y Ma; Michael K M Kam; Thomas W T Leung; Philip J Johnson; Peter H K Choi; Benny C Y Zee Journal: J Natl Cancer Inst Date: 2005-04-06 Impact factor: 13.506
Authors: H Chang; J Gao; B Q Xu; S P Guo; R B Lu; G Li; S M Huang; F Han; Z G Liu; Y L Tao; Z W Tu; C Chen; X H Li; Y F Xia Journal: Clin Oncol (R Coll Radiol) Date: 2013-07-31 Impact factor: 4.126
Authors: A T C Chan; P M L Teo; R K Ngan; T W Leung; W H Lau; B Zee; S F Leung; F Y Cheung; W Yeo; H H Yiu; K H Yu; K W Chiu; D T Chan; T Mok; K T Yuen; F Mo; M Lai; W H Kwan; P Choi; P J Johnson Journal: J Clin Oncol Date: 2002-04-15 Impact factor: 44.544
Authors: Wedad Saeed Al-Qahtani; Tahani Mohamed Al-Hazani; Fatmah Ahmed Safhi; Mashael Alhumaidi Alotaibi; Dalia Mostafa Domiaty; Salha M S Al-Shamrani; Eman Alshehri; Amani Mohammed Alotaibi; Saad Alkahtani Journal: Asian Pac J Cancer Prev Date: 2021-09-01