1. Prognostic nomogram for refining the prognostication of the proposed 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity‐modulated radiotherapy
- Author
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Pan, Jian Ji, Ng, Wai Tong, Zong, Jing Feng, Lee, Sarah WM, Choi, Horace CW, Chan, Lucy LK, Lin, Shao Jun, Guo, Qiao Juan, Sze, Henry CK, Bin Chen, Yun, Xiao, You Ping, Kan, Wai Kuen, O'Sullivan, Brian, Xu, Wei, Le, Quynh Thu, Glastonbury, Christine M, Colevas, A Dimitrios, Weber, Randal S, Lydiatt, William, Shah, Jatin P, and Lee, Anne WM
- Subjects
Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Clinical Research ,Cancer ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,Child ,Female ,Follow-Up Studies ,Humans ,L-Lactate Dehydrogenase ,Male ,Middle Aged ,Nasopharyngeal Neoplasms ,Neoplasm Staging ,Nomograms ,Prognosis ,Radiotherapy ,Intensity-Modulated ,Retrospective Studies ,Survival Rate ,Young Adult ,intensity-modulated radiotherapy ,nasopharyngeal carcinoma ,nomogram ,prognostication ,TNM staging ,Public Health and Health Services ,Oncology & Carcinogenesis ,Oncology and carcinogenesis ,Public health - Abstract
BackgroundThe objective of this study was to develop a nomogram for refining prognostication for patients with nondisseminated nasopharyngeal cancer (NPC) staged with the proposed 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system.MethodsConsecutive patients who had been investigated with magnetic resonance imaging, staged with the proposed 8th edition of the AJCC/UICC staging system, and irradiated with intensity-modulated radiotherapy from June 2005 to December 2010 were analyzed. A cohort of 1197 patients treated at Fujian Provincial Cancer Hospital was used as the training set, and the results were validated with 412 patients from Pamela Youde Nethersole Eastern Hospital. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (c-index). A recursive partitioning algorithm was applied to the survival scores of the combined set to categorize the patients into 3 risk groups.ResultsA multivariate analysis showed that age, gross primary tumor volume, and lactate dehydrogenase were independent prognostic factors for OS in addition to the stage group. The OS nomogram based on all these factors had a statistically higher bias-corrected c-index than prognostication based on the stage group alone (0.712 vs 0.622, P
- Published
- 2016