Open AccessDevelopment and validation of a nomogram for predicting the survival of patients with non‐metastatic nasopharyngeal carcinoma after curative treatment
Author(s) -
Liang Wenhua,
Shen Guanzhu,
Zhang Yaxiong,
Chen Gang,
Wu Xuan,
Li Yang,
Li Anchuan,
Kang Shiyang,
Yuan Xi,
Hou Xue,
Huang Peiyu,
Huang Yan,
Zhao Hongyun,
Tian Ying,
Zhao Chong,
Zhang Li
Publication year - 2016
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-016-0160-9
Subject(s) - nomogram , medicine , nasopharyngeal carcinoma , cohort , stage (stratigraphy) , tnm staging system , proportional hazards model , oncology , radiation therapy , ajcc staging system , concordance , cancer , radiology , staging system , paleontology , biology
Background The TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopathologic factors for predicting the overall survival (OS) of non‐metastatic nasopharyngeal carcinoma (NPC) patients after curative treatments. Methods We retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity‐modulated radiation therapy (IMRT) between 2001 and 2010 were also retrieved to examine the extensibility of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index (c‐index). Results We identified and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c‐index of the nomogram was statistically higher than that of the 7th edition TNM staging system for predicting the survival in both the primary cohort (0.69 vs. 0.62) and the IMRT cohort (0.67 vs. 0.63). Conclusion We developed and validated a novel nomogram that outperformed the TNM staging system in predicting the OS of non‐metastatic NPC patients who underwent curative therapy.