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Complementary role of the Memorial Sloan Kettering Cancer Center nomogram to the American Joint Committee on Cancer system for the prediction of relapse of major salivary gland carcinoma after surgery
Author(s) -
Chou WenChi,
Chang KaiPing,
Lu ChangHsien,
Chen MiaoFen,
Cheng YuFan,
Yeh KunYun,
Wang ChengHsu,
Lin YungChang,
Yeh TaSen
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24702
Subject(s) - nomogram , medicine , salivary gland cancer , cancer , ajcc staging system , stage (stratigraphy) , tnm staging system , concordance , cohort , oncology , surgery , staging system , paleontology , biology
Background The purpose of this study was to test the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in predicting recurrence risk of major salivary gland carcinoma in an Asian cohort. Methods We retrospectively enrolled 149 patients who had undergone intended curative resections for major salivary gland carcinoma between 2007 and 2012. The performance of the MSKCC nomogram and the American Joint Committee on Cancer (AJCC) seventh staging system in predicting recurrence risk was compared. Results The MSKCC nomogram and the AJCC staging system both accurately predicted the 5‐year recurrence probabilities, with the concordance index (c‐index = 0.82; 95% confidence interval [CI], 0.75–0.89 vs c‐index, 0.77; 95% CI, 0.68–0.87; p = .45) in patients with major salivary gland carcinomas after curative surgeries. Comparing to the actual observed events, the calibration plot indicated that the MSKCC nomogram accurately estimated the recurrence in low‐risk groups but tended to overestimate in high‐risk groups. When using the MSKCC nomogram to predict the 5‐year recurrence‐free probability in each AJCC stage, the prediction was very good for patients with AJCC stages I and II disease (c‐index = 0.92 and 0.90, respectively) and modest for those of AJCC stages III and IVa (c‐index = 0.51 and 0.62, respectively). Conclusion The MSKCC nomogram and the AJCC staging system each had its value in predicting recurrence of major salivary gland cancers. When using the MSKCC nomogram to predict the 5‐year recurrence‐free probability in each AJCC stage, the MSKCC nomogram was more accurate in predicting recurrence risks in those patients with AJCC stage I and II diseases than those with late‐stage diseases. © 2017 Wiley Periodicals, Inc. Head Neck 39: 860–867, 2017