Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram
Objective: We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Ext...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-03-01
|
| Series: | Brazilian Journal of Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869423001313 |
| _version_ | 1797234375326171136 |
|---|---|
| author | Jianming Ding Jiawei Chen Yuhao Lin Jiabiao Hong Chaoxiong Huang Zhaodong Fei Chuanben Chen |
| author_facet | Jianming Ding Jiawei Chen Yuhao Lin Jiabiao Hong Chaoxiong Huang Zhaodong Fei Chuanben Chen |
| author_sort | Jianming Ding |
| collection | DOAJ |
| description | Objective: We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). Methods: Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. Results: A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71–0.78) in the training cohort and 0.76 (0.69–0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2 year and 0.75 vs. 0.65 for 3 year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. Conclusions: We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. Level of evidence: III. |
| first_indexed | 2024-03-08T23:13:02Z |
| format | Article |
| id | doaj.art-fb272b4adf9a41949eea50637253d7f9 |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-04-24T16:31:04Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-fb272b4adf9a41949eea50637253d7f92024-03-30T04:38:53ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942024-03-01902101363Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogramJianming Ding0Jiawei Chen1Yuhao Lin2Jiabiao Hong3Chaoxiong Huang4Zhaodong Fei5Chuanben Chen6Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaClinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaClinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaClinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaClinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaClinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaCorresponding author.; Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Department of Radiation Oncology, Fujian, PR ChinaObjective: We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). Methods: Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. Results: A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71–0.78) in the training cohort and 0.76 (0.69–0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2 year and 0.75 vs. 0.65 for 3 year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. Conclusions: We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. Level of evidence: III.http://www.sciencedirect.com/science/article/pii/S1808869423001313Nasopharyngeal carcinomaNomogramPrognosisPrimary gross tumor volume and radiologic extranodal extension |
| spellingShingle | Jianming Ding Jiawei Chen Yuhao Lin Jiabiao Hong Chaoxiong Huang Zhaodong Fei Chuanben Chen Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram Brazilian Journal of Otorhinolaryngology Nasopharyngeal carcinoma Nomogram Prognosis Primary gross tumor volume and radiologic extranodal extension |
| title | Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram |
| title_full | Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram |
| title_fullStr | Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram |
| title_full_unstemmed | Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram |
| title_short | Significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis: a comprehensive nomogram |
| title_sort | significance of radiologic extranodal extension in locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis a comprehensive nomogram |
| topic | Nasopharyngeal carcinoma Nomogram Prognosis Primary gross tumor volume and radiologic extranodal extension |
| url | http://www.sciencedirect.com/science/article/pii/S1808869423001313 |
| work_keys_str_mv | AT jianmingding significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT jiaweichen significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT yuhaolin significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT jiabiaohong significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT chaoxionghuang significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT zhaodongfei significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram AT chuanbenchen significanceofradiologicextranodalextensioninlocoregionallyadvancednasopharyngealcarcinomawithlymphnodemetastasisacomprehensivenomogram |