scholarly journals Development and validation of a nomogram to predict cancer-specific survival in patients with hypopharyngeal squamous cell carcinoma treated with primary surgery

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110674
Author(s):  
Ke Wang ◽  
Xia Xu ◽  
Ruotao Xiao ◽  
Danyi Du ◽  
Luqi Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Risk Stratification ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Net Benefit ◽  
Cancer Specific Survival ◽  
Hypopharyngeal Squamous Cell Carcinoma ◽  
Primary Surgery ◽  
Kaplan Meier ◽  
Ajcc Staging

Objective We aimed to develop a nomogram to predict cancer-specific survival (CSS) in patients with hypopharyngeal squamous cell carcinoma (HSCC) treated with primary surgery to provide more accurate risk stratification for patients. Methods We retrospectively collected data of 1144 eligible patients with HSCC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Patients were randomly divided into training and validation groups (ratio 6:4) and we used univariate and multivariate Cox analysis. We developed and validated a nomogram using calibration plots and time-dependent receiver operating characteristic, Kaplan–Meier, and decision curves. Results Age; marital status; T, N, and M stage; and postoperative adjuvant therapy were independent factors associated with CSS, which were included in the nomogram. The nomogram’s C-index was 0.705 to 0.723 in the training group and 0.681 to 0.736 in the validation group, which were significantly higher than conventional American Joint Committee on Cancer (AJCC) staging. Calibration curves showed good agreement between prediction and observation in both groups. Kaplan–Meier and decision curves suggested the nomogram had better risk stratification and net benefit than conventional AJCC staging. Conclusions We established a nomogram that was superior to conventional AJCC staging in predicting CSS for HSCC.

scholarly journals Treatment patterns and survival outcomes in advanced hypopharyngeal squamous cell carcinoma

2020 ◽  
Author(s):  
Yao-Te Tsai ◽  
Wen-Cheng Chen ◽  
Chih-Yen Chien ◽  
Cheng-Ming Hsu ◽  
Yi-Chan Lee ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Primary Treatment ◽  
Free Survival ◽  
Hypopharyngeal Squamous Cell Carcinoma ◽  
Primary Surgery ◽  
Kaplan Meier

Abstract Background This study aimed to evaluate the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment of hypopharyngeal squamous cell carcinoma (HPSCC). Methods A retrospective cohort study of HPSCC patients with stage III-IV HPSCC in four tertiary referral centers consecutively enrolled from 2003 to 2012, total of 213 (32.6%) patients received PS, and 439 (67.4%) patients received CCRT as their primary treatment. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method and Cox regression models. Results The 5-year OS and DFS for patients undergoing PS and CCRT were 45.0% vs 33.1% and 36.2% vs 28.9% ( p < 0.001 and 0.003, respectively). In subgroup analysis, PS was associated with better OS in patients with stage IVA of the disease ( p = 0.002), specifically in those with T4 or N2 classification ( p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stages IVA and IVB and CCRT were independent adverse prognostic factors for OS ( p = 0.004, <0.001, and 0.014, respectively). Furthermore, CCRT was also significantly associated with lower OS rates than PS in stage IVA patients more than 65 years of age and with N2 classification ( p = 0.027 and 0.010, respectively). Conclusions In patients with advanced HPSCC, PS was significantly associated with better prognosis and should be considered a favorable primary treatment in patients with stage IVA of the disease, especially if they are over 65 years of age or have T4 and N2 classification.

scholarly journals Treatment patterns and survival outcomes of advanced hypopharyngeal squamous cell carcinoma

2020 ◽  
Author(s):  
Yao-Te Tsai ◽  
Wen-Cheng Chen ◽  
Chih-Yen Chien ◽  
Cheng-Ming Hsu ◽  
Yi-Chan Lee ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Primary Treatment ◽  
Hypopharyngeal Squamous Cell Carcinoma ◽  
Primary Surgery ◽  
Kaplan Meier ◽  
Primary Treatment Modality

Abstract Background: This study evaluated the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment for hypopharyngeal squamous cell carcinoma (HPSCC).Methods: This retrospective cohort study included patients with stage III-IV HPSCC from four tertiary referral centers consecutively enrolled from 2003 to 2012; of them, 213 (32.6%) and 439 (67.4%) had received PS and CCRT as their primary treatments, respectively. The 5-year overall survival (OS) and disease-free survival (DFS) rates were analyzed using the Kaplan-Meier method and Cox regression models.Results: In patients undergoing PS and CCRT, OS rates were 45.0% and 33.1% (p < 0.001), respectively, and DFS rates were 36.2% and 28.9% (p = 0.003), respectively. In subgroup analysis, in patients with stage IVA HPSCC, PS was associated with higher OS rate (p = 0.002), particularly in those with T4 or N2 classification (p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stages IVA HPSCC, stage IVB HPSCC, and CCRT were independent adverse prognostic factors for OS rate (p = 0.004, <0.001, and 0.014, respectively). Furthermore, in patients with stage IVA HPSCC aged ≥ 65 years and with N2 classification, CCRT was significantly associated with lower OS rates than was PS (p = 0.027 and 0.010, respectively).Conclusions: In patients with advanced HPSCC, PS was significantly associated with better prognosis than CCRT. PS could be a favorable primary treatment modality for the management of patients with stage IVA HPSCC, particularly those aged ≥ 65 years and with T4 and N2 classification.

scholarly journals Primary Surgery vs Chemoradiation Treatment of Advanced-Stage Hypopharyngeal Squamous Cell Carcinoma

2015 ◽  
Vol 141 (7) ◽  
pp. 636 ◽  
Author(s):  
Brianna N. Harris ◽  
Vincent L. Biron ◽  
Paul Donald ◽  
D. Gregory Farwell ◽  
Quang C. Luu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Advanced Stage ◽  
Hypopharyngeal Squamous Cell Carcinoma ◽  
Primary Surgery ◽  
Chemoradiation Treatment

scholarly journals A novel prognostic model predicting the long-term cancer-specific survival for patients with hypopharyngeal squamous cell carcinoma

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xin Tang ◽  
Tong Pang ◽  
Wei-feng Yan ◽  
Wen-lei Qian ◽  
You-ling Gong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Classification System ◽  
Poor Prognosis ◽  
Prognostic Model ◽  
Validation Cohort ◽  
Cancer Specific Survival ◽  
Hypopharyngeal Squamous Cell Carcinoma

Abstract Background Hypopharyngeal squamous cell carcinoma (HSCC) is a rare type of head and neck cancer with poor prognosis. However, till now, there is still no model predicting the survival outcomes for HSCC patients. We aim to develop a novel nomogram predicting the long-term cancer-specific survival (CSS) for patients with HSCC and establish a prognostic classification system. Methods Data of 2021 eligible HSCC patients were retrieved from the Surveillance, Epidemiology and End Results database between 2010 and 2015. We randomly split the whole cases (ratio: 7:3) into the training and the validation cohort. Cox regression as well as the Least absolute shrinkage and selection operator (LASSO) COX were used to select significant predictors of CSS. Based on the beta-value of these predictors, a novel nomogram was built. The concordance index (C-index), the calibration curve and the decision curve analysis (DCA) were utilized for the model validation and evaluation using the validation cohort. Results In total, cancer-specific death occurred in 974/2021 (48.2%) patients. LASSO COX indicated that age, race, T stage, N stage, M stage, surgery, radiotherapy and chemotherapy are significant prognosticators of CSS. A prognostic model based on these factors was constructed and visually presented as nomogram. The C-index of the model was 0.764, indicating great predictive accuracy. Additionally, DCA and calibration curves also demonstrated that the nomogram had good clinical effect and satisfactory consistency between the predictive CSS and actual observation. Furthermore, we developed a prognostic classification system that divides HSCC patients into three groups with different prognosis. The median CSS for HSCC patients in the favorable, intermediate and poor prognosis group was not reached, 39.0-Mo and 10.0-Mo, respectively (p < 0.001). Conclusions In this study, we constructed the first nomogram as well as a relevant prognostic classification system that predicts CSS for HSCC patients. We believe these tools would be helpful for clinical practice in patients’ consultation and risk group stratification.

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