Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China
Abstract Objective Nasopharyngeal carcinoma (NPC) is prevailing in Southern China, characterized by distinct geographical distribution. Aimed to predict the overall survival (OS) of patients with nasopharyngeal carcinoma, this study developed and validated nomograms considering demographic variables...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Cancer Cell International |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12935-022-02776-8 |
| _version_ | 1811219363710107648 |
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| author | Siwei Miao Haike Lei Xiaosheng Li Wei Zhou Guixue Wang Anlong Sun Ying Wang Yongzhong Wu |
| author_facet | Siwei Miao Haike Lei Xiaosheng Li Wei Zhou Guixue Wang Anlong Sun Ying Wang Yongzhong Wu |
| author_sort | Siwei Miao |
| collection | DOAJ |
| description | Abstract Objective Nasopharyngeal carcinoma (NPC) is prevailing in Southern China, characterized by distinct geographical distribution. Aimed to predict the overall survival (OS) of patients with nasopharyngeal carcinoma, this study developed and validated nomograms considering demographic variables, hematological biomarkers, and oncogenic pathogens in China. Methods The clinicopathological and follow-up data of the nasopharyngeal carcinoma patients obtained from a prospective longitudinal cohort study in the Chongqing University Cancer Hospital between Jan 1, 2017 and Dec 31, 2019 ( $$\mathrm{n}=1635$$ n = 1635 ). Cox regression model was used to tested the significance of all available variables as prognostic factors of OS. And independent prognostic factors were identified based on multivariable analysis to model nomogram. Concordance index (C-index), area under the receiver operating characteristic (AUC), calibration curve, and decision curve analysis (DCA) were measured to assess the model performance of nomogram. Results Data was randomly divided into a training cohort (1227 observers, about 70% of data) and a validation group (408 observers, about 30% of data). At multivariable analysis, the following were independent predictors of OS in NPC patients and entered into the nomogram: age (hazard ratio [HR]: 1.03), stage (stage IV vs. stage I–II, HR: 4.54), radiotherapy (Yes vs. No, HR: 0.43), EBV ( $$\ge 1000$$ ≥ 1000 vs. $$<1000$$ < 1000 , HR: 1.92), LAR ( $$>6.15$$ > 6.15 vs. $$\le 6.15$$ ≤ 6.15 , HR: 2.05), NLR ( $$>4.84$$ > 4.84 vs. $$\le 4.84$$ ≤ 4.84 HR: 1.54), and PLR ( $$>206.33$$ > 206.33 vs. $$\le 206.33$$ ≤ 206.33 , HR: 1.79). The C-indexes for training cohort at 1-, 3- and 5-year were 0.73, 0.83, 0.80, respectively, in the validation cohort, the C-indexes were 0.74 (95% CI 0.63–0.86), 0.80 (95% CI 0.73–0.87), and 0.77 (95% CI 0.67–0.86), respectively. The calibration curve demonstrated that favorable agreement between the predictions of the nomograms and the actual observations in the training and validation cohorts. In addition, the decision curve analysis proved that the nomogram model had the highest overall net benefit. Conclusion A new prognostic model to predict OS of patients with NPC was developed. This can offer clinicians treatment making and patient counseling. Furthermore, the nomogram was deployed into a website server for use. |
| first_indexed | 2024-04-12T07:26:02Z |
| format | Article |
| id | doaj.art-5d5cc74e9304446cbbc32fde73cde3a2 |
| institution | Directory Open Access Journal |
| issn | 1475-2867 |
| language | English |
| last_indexed | 2024-04-12T07:26:02Z |
| publishDate | 2022-11-01 |
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| series | Cancer Cell International |
| spelling | doaj.art-5d5cc74e9304446cbbc32fde73cde3a22022-12-22T03:42:12ZengBMCCancer Cell International1475-28672022-11-0122111110.1186/s12935-022-02776-8Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in ChinaSiwei Miao0Haike Lei1Xiaosheng Li2Wei Zhou3Guixue Wang4Anlong Sun5Ying Wang6Yongzhong Wu7Department of Health Statistics, School of Public Health, Chongqing Medical UniversityChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalMOE Key Lab for Biorheological Science and Technology, State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing UniversityChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalChongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer HospitalAbstract Objective Nasopharyngeal carcinoma (NPC) is prevailing in Southern China, characterized by distinct geographical distribution. Aimed to predict the overall survival (OS) of patients with nasopharyngeal carcinoma, this study developed and validated nomograms considering demographic variables, hematological biomarkers, and oncogenic pathogens in China. Methods The clinicopathological and follow-up data of the nasopharyngeal carcinoma patients obtained from a prospective longitudinal cohort study in the Chongqing University Cancer Hospital between Jan 1, 2017 and Dec 31, 2019 ( $$\mathrm{n}=1635$$ n = 1635 ). Cox regression model was used to tested the significance of all available variables as prognostic factors of OS. And independent prognostic factors were identified based on multivariable analysis to model nomogram. Concordance index (C-index), area under the receiver operating characteristic (AUC), calibration curve, and decision curve analysis (DCA) were measured to assess the model performance of nomogram. Results Data was randomly divided into a training cohort (1227 observers, about 70% of data) and a validation group (408 observers, about 30% of data). At multivariable analysis, the following were independent predictors of OS in NPC patients and entered into the nomogram: age (hazard ratio [HR]: 1.03), stage (stage IV vs. stage I–II, HR: 4.54), radiotherapy (Yes vs. No, HR: 0.43), EBV ( $$\ge 1000$$ ≥ 1000 vs. $$<1000$$ < 1000 , HR: 1.92), LAR ( $$>6.15$$ > 6.15 vs. $$\le 6.15$$ ≤ 6.15 , HR: 2.05), NLR ( $$>4.84$$ > 4.84 vs. $$\le 4.84$$ ≤ 4.84 HR: 1.54), and PLR ( $$>206.33$$ > 206.33 vs. $$\le 206.33$$ ≤ 206.33 , HR: 1.79). The C-indexes for training cohort at 1-, 3- and 5-year were 0.73, 0.83, 0.80, respectively, in the validation cohort, the C-indexes were 0.74 (95% CI 0.63–0.86), 0.80 (95% CI 0.73–0.87), and 0.77 (95% CI 0.67–0.86), respectively. The calibration curve demonstrated that favorable agreement between the predictions of the nomograms and the actual observations in the training and validation cohorts. In addition, the decision curve analysis proved that the nomogram model had the highest overall net benefit. Conclusion A new prognostic model to predict OS of patients with NPC was developed. This can offer clinicians treatment making and patient counseling. Furthermore, the nomogram was deployed into a website server for use.https://doi.org/10.1186/s12935-022-02776-8Nasopharyngeal carcinomaNomogramOverall survivalPrognosis |
| spellingShingle | Siwei Miao Haike Lei Xiaosheng Li Wei Zhou Guixue Wang Anlong Sun Ying Wang Yongzhong Wu Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China Cancer Cell International Nasopharyngeal carcinoma Nomogram Overall survival Prognosis |
| title | Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China |
| title_full | Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China |
| title_fullStr | Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China |
| title_full_unstemmed | Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China |
| title_short | Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China |
| title_sort | development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma a prospective cohort study in china |
| topic | Nasopharyngeal carcinoma Nomogram Overall survival Prognosis |
| url | https://doi.org/10.1186/s12935-022-02776-8 |
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