A Predictive Model for Patients with Local-Regionally Advanced Oropharyngeal Squamous Cell Carcinoma Treated after Cervical Lymph Node Dissection

Abstract

Purpose: To develop a nomogram to predict cancer-specific survival of patients with local-regionally advanced oropharyngeal squamous cell carcinoma after cervical lymph node dissection.

Methods: The clinical variables of patients diagnosed with oropharyngeal squamous cell carcinoma from 2008 to 2015 were retrieved from the Surveillance, Epidemiology and End Results database. Perform univariate and multivariate analysis and build nomogram in cancer-specific survival. The nomograms' accuracy was evaluated through the concordance index, calibration curves and decision curve analysis.

Results: A total of 1,994 oropharyngeal squamous cell carcinoma patients who underwent surgery were included in this study. Gender,T- stage, American Joint Committee on Cancer-Stage, positive lymph node,positive lymph node ratio, log odds of positive lymph nodes ,and postoperative radiotherapy were selected to establish the nomogram for oropharyngeal squamous cell carcinoma. The concordance index of the nomogram was 0.747 (95%CI: 0.714–0.780) in the training calibration and 0.735 (95%CI: 0.68–0.789) in the validationcohort and the time-dependent Area under the curve (>0.7) indicated satisfactory discriminative ability of the nomogram. The calibration plot shows that there is a good consistency between the predictions of the nomogram and the actual observations in the training and validation cohorts. In addition, decision curve analysis shows that the nomogram was clinically useful and had a better ability to identify high-risk patients than the American Joint Committee on Cancer tumor-lymph node-metastasis staging.

Conclusion: The predictive model has the potential to provide valuable guidance to clinicians in the treatment of patients with local-regionally advanced OPSCC confined to the cervical lymph nodes

Note:
Funding Declaration: This study was supported by Key Research and Development Projects of Anhui Province in 2020 (No. 202004j07020043)

Conflicts of Interest: None

Keywords: OPSCC, nomogram, ELN, LNR, LODDS, PORT, SEER