A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy

Abstract Background Postoperative radiotherapy (PORT) is beneficial in the improvement of local‐regional control and overall survival (OS) for major salivary gland carcinomas (SGCs), and distant metastasis remained the main failure pattern. This study was designed to develop a nomogram model involvi...

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Main Authors: Wenbin Yan, Xiaomin Ou, Chunying Shen, Chaosu Hu
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5167
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author Wenbin Yan
Xiaomin Ou
Chunying Shen
Chaosu Hu
author_facet Wenbin Yan
Xiaomin Ou
Chunying Shen
Chaosu Hu
author_sort Wenbin Yan
collection DOAJ
description Abstract Background Postoperative radiotherapy (PORT) is beneficial in the improvement of local‐regional control and overall survival (OS) for major salivary gland carcinomas (SGCs), and distant metastasis remained the main failure pattern. This study was designed to develop a nomogram model involving immune‐inflammation index to predict distant metastasis‐free survival (DMFS) of major SGCs. Patients and Methods A total of 418 patients with major SGCs following PORT were randomly divided into a training (n = 334) and validation set (n = 84). The pre‐radiotherapy neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) were calculated and transformed as continuous variables for every patient. Associations between DMFS and variables were performed by univariate and multivariable analysis using Log‐rank and Cox regression methods. A nomogram was constructed based on the prognostic factors identified by the Cox hazards model. The decision curve analysis (DCA) was conducted with the training and validation set. Results The estimated 3‐, 5‐, and 10‐year DMFS were 79.4%, 71.8%, and 59.1%, respectively. The multivariate analysis revealed that age (p = 0.033), advanced T stage (p = 0.003), positive N stage (p < 0.001), high‐risk pathology (p = 0.011), and high PLR (p = 0.001) were significantly associated with worse DMFS. The nomogram showed good calibration and discrimination in the training (AUC = 80.9) and validation set (AUC = 87.9). Furthermore, the DCA demonstrated favorable applicability, and a significant difference (p < 0.001) was observed for the DMFS between the subgroups based on the nomogram points. Conclusion The nomogram incorporating clinicopathological features and PLR presented accurate individual prediction for DMFS of the patients with major SGCs following PORT. Further external validation of the model is warranted for clinical utility.
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spelling doaj-art-41a015d259df4382be42ac79c6dfe8e42025-08-20T02:33:05ZengWileyCancer Medicine2045-76342023-02-011232772278110.1002/cam4.5167A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapyWenbin Yan0Xiaomin Ou1Chunying Shen2Chaosu Hu3Department of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaAbstract Background Postoperative radiotherapy (PORT) is beneficial in the improvement of local‐regional control and overall survival (OS) for major salivary gland carcinomas (SGCs), and distant metastasis remained the main failure pattern. This study was designed to develop a nomogram model involving immune‐inflammation index to predict distant metastasis‐free survival (DMFS) of major SGCs. Patients and Methods A total of 418 patients with major SGCs following PORT were randomly divided into a training (n = 334) and validation set (n = 84). The pre‐radiotherapy neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) were calculated and transformed as continuous variables for every patient. Associations between DMFS and variables were performed by univariate and multivariable analysis using Log‐rank and Cox regression methods. A nomogram was constructed based on the prognostic factors identified by the Cox hazards model. The decision curve analysis (DCA) was conducted with the training and validation set. Results The estimated 3‐, 5‐, and 10‐year DMFS were 79.4%, 71.8%, and 59.1%, respectively. The multivariate analysis revealed that age (p = 0.033), advanced T stage (p = 0.003), positive N stage (p < 0.001), high‐risk pathology (p = 0.011), and high PLR (p = 0.001) were significantly associated with worse DMFS. The nomogram showed good calibration and discrimination in the training (AUC = 80.9) and validation set (AUC = 87.9). Furthermore, the DCA demonstrated favorable applicability, and a significant difference (p < 0.001) was observed for the DMFS between the subgroups based on the nomogram points. Conclusion The nomogram incorporating clinicopathological features and PLR presented accurate individual prediction for DMFS of the patients with major SGCs following PORT. Further external validation of the model is warranted for clinical utility.https://doi.org/10.1002/cam4.5167distant metastasisnomogrampostoperative radiotherapysalivary gland carcinoma
spellingShingle Wenbin Yan
Xiaomin Ou
Chunying Shen
Chaosu Hu
A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
Cancer Medicine
distant metastasis
nomogram
postoperative radiotherapy
salivary gland carcinoma
title A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
title_full A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
title_fullStr A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
title_full_unstemmed A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
title_short A nomogram involving immune‐inflammation index for predicting distant metastasis‐free survival of major salivary gland carcinoma following postoperative radiotherapy
title_sort nomogram involving immune inflammation index for predicting distant metastasis free survival of major salivary gland carcinoma following postoperative radiotherapy
topic distant metastasis
nomogram
postoperative radiotherapy
salivary gland carcinoma
url https://doi.org/10.1002/cam4.5167
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