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Optimizing Survival Predictions of Hypopharynx Cancer: Development of a Clinical Prediction Model
Author(s) -
Arends Coralie R.,
Petersen Japke F.,
Noort Vincent,
Timmermans Adriana J.,
Leemans C. René,
Bree Remco,
Brekel Michiel W.M.,
Stuiver Martijn M.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28345
Subject(s) - medicine , proportional hazards model , lasso (programming language) , body mass index , oncology , cancer , retrospective cohort study , cohort , statistic , hazard ratio , statistics , confidence interval , computer science , mathematics , world wide web
Objectives To develop and validate a clinical prediction model (CPM) for survival in hypopharynx cancer, thereby aiming to improve individualized estimations of survival. Methods Retrospective cohort study of hypopharynx cancer patients. We randomly split the cohort into a derivation and validation dataset. The model was fitted on the derivation dataset and validated on the validation dataset. We used a Cox's proportional hazard model and least absolute shrinkage and selection operator (LASSO) selection. Performance (discrimination and calibration) of the CPM was tested. Results The final model consisted of gender, subsite, TNM classification, Adult Comorbidity Evaluation‐27 score (ACE27), body mass index (BMI), hemoglobin, albumin, and leukocyte count. Of these, TNM classification, ACE27, BMI, hemoglobin, and albumin had independent significant associations with survival. The C Statistic was 0.62 after validation. The model could significantly identify clinical risk groups. Conclusions ACE27, BMI, hemoglobin, and albumin are independent predictors of overall survival. The identification of high‐risk patients can be used in the counseling process and tailoring of treatment strategy or follow‐up. Level of Evidence 4 Laryngoscope , 130:2166–2172, 2020