A Nomogram Based on Serum Biomarkers and Clinical Characteristics to Predict Survival in Patients With Non-Metastatic Nasopharyngeal Carcinoma

This study focused on developing an effective nomogram for improving prognostication for patients with primary nasopharyngeal carcinoma (NPC) restaged according to the eighth edition of the AJCC/UICC TNM staging system. Based on data of 5,903 patients with non-metastatic NPC (primary cohort), we use...

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Published inFrontiers in oncology Vol. 10; p. 594363
Main Authors Li, Qing-Jie, Mao, Yan-Ping, Guo, Rui, Huang, Cheng-Long, Fang, Xue-Liang, Ma, Jun, Tang, Ling-Long, Chen, Lei
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 10.12.2020
Subjects
nasopharyngeal carcinoma
nomogram
Oncology
prognostic prediction
serum biomarkers
survival
prognostic prediction
nasopharyngeal carcinoma
nomogram
serum biomarkers
survival
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Summary:This study focused on developing an effective nomogram for improving prognostication for patients with primary nasopharyngeal carcinoma (NPC) restaged according to the eighth edition of the AJCC/UICC TNM staging system. Based on data of 5,903 patients with non-metastatic NPC (primary cohort), we used Cox regression analysis to identify survival risk factors and created a nomogram. We used the nomogram to predict overall survival (OS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) in the primary and independent validation (3,437 patients) cohorts. Moreover, we compared the prognostic accuracy between the 8th TNM system and the nomogram. The nomogram included gender, age, T stage, N stage, Epstein-Barr virus DNA, hemoglobin, C-reactive protein, lactate dehydrogenase, and radiotherapy with/without induction or concurrent chemotherapy. In the prediction of OS, DMFS and DFS, the nomogram had significantly higher concordance index (C-index) and area under ROC curve (AUC) than the TNM system alone. Calibration curves demonstrated satisfactory agreements between nomogram-predicted and observed survival. The stratification in different groups permitted remarkable differentiation among Kaplan-Meier curves for OS, DMFS, and DFS. The nomogram led to a more precise prognostic prediction for NPC patients in comparison with the 8th TNM system. Therefore, it could facilitate individualized and personalized patients' counseling and care.
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This article was submitted to Head and Neck Cancer, a section of the journal Frontiers in Oncology
Edited by: Fan Zhang, Fifth Affiliated Hospital of Sun Yat-sen University, China
These authors have contributed equally to this work
Reviewed by: Lina Zhao, Fourth Military Medical University, China; Shao-Bo Liang, First People’s Hospital of Foshan, China; Yufeng Ren, First Affiliated Hospital of Sun Yat-Sen University, China
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2020.594363