Open AccessPrognostic models for early and late tumor progression prediction in nasopharyngeal carcinoma: An analysis of 8292 endemic cases
Author(s) -
Zhang LuLu,
Zheng Weihong,
Zhu Weijie,
Deng QiLing,
Peng JunLing,
Li YiYang,
Sun Ying,
Lin Li
Publication year - 2023
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.5361
Subject(s) - nomogram , medicine , nasopharyngeal carcinoma , cohort , concordance , tumor progression , logistic regression , oncology , radiation therapy , cancer
Objectives The time for posttreatment tumor progression differs between nasopharyngeal carcinoma (NPC) patients. Herein, we established effective nomograms for predicting early tumor progression (ETP) and late tumor progression (LTP) in NPC patients. Methods We retrospectively enrolled 8292 NPC patients (training cohort: n = 6219; validation cohort: n = 2073). The ELP and LTP were defined as the time to tumor progression ≤24 and >24 months after treatment, respectively. Results The ETP and LTP accounted for 52.6 and 47.4% of the total patient cohort, respectively. Patients who developed ETP had markedly worse overall survival (OS) versus patients who suffered from LTP (5‐year OS: 26.2% vs. 59.7%, p < 0.001). Further, we identified 10/6 predictive factors significantly associated with ETP/LTP via logistic regression analyses. These indicators were used separately to construct two predictive nomograms for ETP and LTP. In the training group, the ETP nomogram [Harrell Concordance Index (C‐index) value: 0.711 vs. 0.618; p < 0.001] and LTP nomogram (C‐index value: 0.701 vs. 0.612; p < 0.001) were significantly superior for risk stratification than the TNM staging. These results were supported in the validation group with a C‐index value of 0.753 and 0.738 for the ETP and LTP nomograms, respectively. High‐risk patients defined by ETP/LTP nomograms had shorter progression‐free survival than low‐risk patients (all p < 0.001). Conclusion The established nomograms can help in ELP or LTP risk stratification for NPC patients. Our current results might also provide insights into individualized treatment decisions and designing surveillance strategies for NPC patients.