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Prognostic models for early and late tumor progression prediction in nasopharyngeal carcinoma: An analysis of 8292 endemic cases
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Prognostic models for early and late tumor progression prediction in nasopharyngeal carcinoma: An analysis of 8292 endemic cases
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Journal Article
Prognostic models for early and late tumor progression prediction in nasopharyngeal carcinoma: An analysis of 8292 endemic cases
2023
Overview
Objectives
The time for posttreatment tumor progression differs between nasopharyngeal carcinoma (NPC) patients. Herein, we established effective nomograms for predicting early tumor progression (ETP) and late tumor progression (LTP) in NPC patients.
Methods
We retrospectively enrolled 8292 NPC patients (training cohort: n = 6219; validation cohort: n = 2073). The ELP and LTP were defined as the time to tumor progression ≤24 and >24 months after treatment, respectively.
Results
The ETP and LTP accounted for 52.6 and 47.4% of the total patient cohort, respectively. Patients who developed ETP had markedly worse overall survival (OS) versus patients who suffered from LTP (5‐year OS: 26.2% vs. 59.7%, p < 0.001). Further, we identified 10/6 predictive factors significantly associated with ETP/LTP via logistic regression analyses. These indicators were used separately to construct two predictive nomograms for ETP and LTP. In the training group, the ETP nomogram [Harrell Concordance Index (C‐index) value: 0.711 vs. 0.618; p < 0.001] and LTP nomogram (C‐index value: 0.701 vs. 0.612; p < 0.001) were significantly superior for risk stratification than the TNM staging. These results were supported in the validation group with a C‐index value of 0.753 and 0.738 for the ETP and LTP nomograms, respectively. High‐risk patients defined by ETP/LTP nomograms had shorter progression‐free survival than low‐risk patients (all p < 0.001).
Conclusion
The established nomograms can help in ELP or LTP risk stratification for NPC patients. Our current results might also provide insights into individualized treatment decisions and designing surveillance strategies for NPC patients.
We successfully constructed and validated two nomograms to facilitate early tumor progression (ETP) and late tumor progression (LEP) risk stratification for NPC patients. The ETP and LTP nomograms demonstrated that the high‐isk group had a shorter progression‐free survival (PFS) than the low‐risk group. Moreover, this study facilitated the prediction of ETP or LTP risk, which might also provide valuable insights into treatment decisions and designing surveillance strategies for NPC after definitive treatment.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
Subject
