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Shi J, Liu S, Cao J, Shan S, Zhang J, Wang Y. Development and validation of lymph node ratio-based nomograms for primary duodenal adenocarcinoma after surgery. Front Oncol 2022; 12:962381. [PMID: 36276093 PMCID: PMC9584089 DOI: 10.3389/fonc.2022.962381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/20/2022] [Indexed: 12/16/2022] Open
Abstract
BackgroundThe prediction models for primary duodenal adenocarcinoma (PDA) are deficient. This study aimed to determine the predictive value of the lymph node ratio (LNR) in PDA patients and to establish and validate nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) for PDAs after surgical resection.MethodsWe extracted the demographics and clinicopathological information of PDA patients between 2004 and 2018 from the Surveillance, Epidemiology and End Results database. After screening cases, we randomly divided the enrolled patients into training and validation groups. X-tile software was used to obtain the best cut-off value for the LNR. Univariate and multivariate Cox analyses were used in the training group to screen out significant variables to develop nomograms. The predictive accuracy of the nomograms was evaluated by the concordance index (C-index), calibration curves, area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA). Finally, four risk groups were created based on quartiles of the model scores.ResultsA total of 978 patients were included in this study. The best cut-off value for the LNR was 0.47. LNR was a negative predictive factor for both OS and CSS. Age, sex, grade, chemotherapy and LNR were used to construct the OS nomogram, while age, grade, chemotherapy, the number of lymph nodes removed and LNR were incorporated into the CSS nomogram. The C-index, calibration curves and AUC of the training and validation sets revealed their good predictability. DCA showed that the predictive value of the nomograms was superior to that of the American Joint Committee on Cancer (AJCC) TNM staging system (8th edition). In addition, risk stratification demonstrated that patients with higher risk correlated with poor survival.ConclusionsThe LNR was an adverse prognostic determinant for PDAs. The nomograms provided an accurate and applicable tool to evaluate the prognosis of PDA patients after surgery.
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Affiliation(s)
- Jingxiang Shi
- Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
| | - Sifan Liu
- School of Statistics, Tianjin University of Finance and Economics, Tianjin, China
| | - Jisen Cao
- Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
| | - Shigang Shan
- Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
| | - Jinjuan Zhang
- Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- *Correspondence: Yijun Wang, ; Jinjuan Zhang,
| | - Yijun Wang
- Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- *Correspondence: Yijun Wang, ; Jinjuan Zhang,
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Li L, Zhang D, Ma F. Nomogram-Based Prediction of Overall and Disease-Specific Survival in Patients With Postoperative Major Salivary Gland Squamous Cell Carcinoma. Technol Cancer Res Treat 2022; 21:15330338221117405. [PMID: 35950233 PMCID: PMC9379806 DOI: 10.1177/15330338221117405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background : The major salivary gland squamous cell carcinoma is a
rare head and neck tumor, often accompanied by lymph node metastasis. Even if
the patient undergoes surgery, the prognosis remains unsatisfactory. To explore
the prognostic factors of postoperative major salivary gland squamous cell
carcinoma to establish a prognostic risk stratification model to guide clinical
practice. Methods: Patients’ information was retrieved from the
Surveillance, Epidemiology, and End Results database from 2004 to 2018. Optimal
cutoff points were determined using X-tile software, and overall survival and
disease-specific survival were calculated by the Kaplan-Meier method.
Independent prognostic factors affecting the overall survival and
disease-specific survival were identified by multivariate analysis, and
corresponding 2 nomogram models were constructed. The discriminative ability and
calibration of nomograms were evaluated by the Concordance index, area under
curves, and calibration plots. Results: A total of 815 patients
with postoperative major salivary gland squamous cell carcinoma were enrolled.
The cutoff values for the number of lymph nodes were 2, and the cutoff values
for the lymph node ratio were 0.11 and 0.5, respectively. Age, T stage, tumor
size, lymph nodes, lymph node ratio, and radiotherapy were prognostic factors
for overall survival and disease-specific survival. Nomograms for
disease-specific survival and overall survival were established and showed
favorable performance with a higher Concordance index and area under curves than
that of the tumor–node–metastasis stage and Surveillance, Epidemiology, and End
Results stage. The calibration plots of 1-, 3-, and 5-year overall survival and
disease-specific survival also exhibited good consistency. What's more, patients
were divided into low-, moderate-, and high-risk groups according to the scores
calculated by the models. The overall survival and disease-specific survival of
patients in the high-risk group were significantly worse than those in the
moderate- and low-risk group. Conclusions: Our nomogram integrated
clinicopathological features and treatment modality to demonstrate excellent
performance in risk stratification and prediction of survival outcomes in
patients with major salivary gland squamous cell carcinoma after surgery, with
important clinical value.
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Affiliation(s)
- Lixi Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Di Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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