External validity of a prognostic nomogram for locoregionally advanced nasopharyngeal carcinoma based on the 8th edition of the AJCC/UICC staging system: a retrospective cohort study.
External validity of a prognostic nomogram for locoregionally advanced nasopharyngeal carcinoma based on the 8th edition of the AJCC/UICC staging system: a retrospective cohort study.
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基于第 8 版 AJCC/UICC 分期系统的局部晚期鼻咽癌预后列线图的外部有效性：一项回顾性队列研究
DOI：
10.1186/s40880-018-0324-x
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发表时间：
2018-09-03
期刊：
影响因子：
--
通讯作者：
Xie FY
中科院分区：
文献类型：
--
作者：
OuYang PY;You KY;Zhang LN;Xiao Y;Zhang XM;Xie FY
肿瘤淋巴结转移（TNM）分期系统不能很好地指导局部晚期鼻咽癌（NPC）患者的个体化诱导或辅助化疗。我们试图从外部验证Pan的列线图，该列线图是基于第8版美国癌症联合委员会（AJCC）/国际癌症控制联盟（UICC）分期系统开发的，用于局部晚期疾病患者。此外，我们调查的可靠性Pan的诺模图选择的参与者在未来的临床试验。该研究包括2007年3月至2012年1月期间接受治疗的535例局部晚期NPC患者。采用Kaplan-Meier方法计算5年总生存率（OS），并与预测结果进行比较。使用校准图和Hosmer-Lemeshow检验来测试校准。辨别能力，这是使用一致性指数进行评估，与其他预测。观察到Pan列线图将整个队列的5年OS低估了8.65% [95%置信区间（CI）-9.70至7.60%，P < 0.001]，并低估了每个风险组的5年OS。在低风险患者中，预测和观察到的5年OS率之间的差异最小（< 135分，使用Pan诺模图计算;预测值减去观察到的OS，-6.41%，95%CI-6.75至6.07%，P < 0.001），并且在高风险患者中最大（≥ 160分）（− 13.56%，95%CI − 15.48至− 11.63%，P < 0.001）。Hosmer-Lemeshow检验显示预测的5年OS率与实际观察的5年OS率之间没有理想的相关性（P < 0.001）。Pan's nomogram与EB病毒DNA酸（EBV DNA）水平和AJCC/UICC第7、8期分期系统比较，具有较好的区分能力，但与EBV DNA和第8期分期系统的联合比较，则无明显差异。此外，Pan的列线图略低于我们的预测模型，包括第8 AJCC/UICC N-分类，年龄，总原发肿瘤体积，乳酸脱氢酶和体重指数。Pan的列线图低估了我们癌症中心局部晚期NPC患者的5年OS，可能不是选择临床试验参与者的精确工具。
The tumor–node–metastasis (TNM) staging system does not perform well for guiding individualized induction or adjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). We attempted to externally validate the Pan’s nomogram, developed based on the 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system, for patients with locoregionally advanced disease. In addition, we investigated the reliability of Pan’s nomogram for selection of participants in future clinical trials. This study included 535 patients with locoregionally advanced NPC who were treated between March 2007 and January 2012. The 5-year overall survival (OS) rates were calculated using the Kaplan–Meier method and compared with predicted outcomes. The calibration was tested using calibration plots and the Hosmer–Lemeshow test. Discrimination ability, which was assessed using the concordance index, as compared with other predictors. Pan’s nomogram was observed to underestimate the 5-year OS of the entire cohort by 8.65% [95% confidence interval (CI) − 9.70 to − 7.60%, P < 0.001] and underestimated the 5-year OS of each risk group. The differences between the predicted and observed 5-year OS rates were smallest among low-risk patients (< 135 points calculated using Pan’s nomogram; which predicted minus observed OS, − 6.41%, 95% CI − 6.75 to − 6.07%, P < 0.001) and were largest among high-risk patients (≥ 160 points) (− 13.56%, 95% CI − 15.48 to − 11.63%, P < 0.001). The Hosmer–Lemeshow test suggested that the predicted and observed 5-year OS rates had no ideal relationship (P < 0.001). Pan’s nomogram had better discriminatory ability compared with the levels of Epstein–Barr virus DNA acid (EBV DNA) and the 7th or 8th AJCC/UICC staging system, although not better compared with the combination of EBV DNA and the 8th staging system. Additionally, Pan’s nomogram was marginally inferior to our predictive model, which included the 8th AJCC/UICC N-classification, age, gross primary tumor volume, lactate dehydrogenase, and body mass index. Pan’s nomogram underestimated the 5-year OS of patients with locoregionally advanced NPC at our cancer center, and may not be a precise tool for selecting participants for clinical trials.
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影响因子：
--
作者：
He YX;Wang Y;Cao PF;Shen L;Zhao YJ;Zhang ZJ;Chen DM;Yang TB;Huang XQ;Qin Z;Dai YY;Shen LF
通讯作者：
Shen LF
影响因子：
2.2
作者：
Song C;Yang S
通讯作者：
Yang S
治疗前高血清乳酸脱氢酶水平与疾病复发相关，并预测局部晚期鼻咽癌的较差预后
影响因子：
8.4
作者：
Wan, Xiang-bo;Wei, Li;Hong, Ming-huang
通讯作者：
Hong, Ming-huang
影响因子：
45.3
作者：
Hui, Edwin P.;Ma, Brigette B.;Chan, Anthony T.
通讯作者：
Chan, Anthony T.
影响因子：
50.5
作者：
Fountzilas, G.;Ciuleanu, E.;Ciuleanu, T.
通讯作者：
Ciuleanu, T.