A nomogram for predicting survival in Patients with oral tongue keratinized squamous cell carcinoma: A SEER-based study

Zishun Qin; Zonghao Hu; Minqin Lai; Feng Wang; Xiaoyuan Liu; Lihua Yin

doi:10.1016/j.jormas.2023.101422

A nomogram for predicting survival in Patients with oral tongue keratinized squamous cell carcinoma: A SEER-based study

J Stomatol Oral Maxillofac Surg. 2023 Sep;124(4):101422. doi: 10.1016/j.jormas.2023.101422. Epub 2023 Feb 11.

Authors

Zishun Qin¹, Zonghao Hu², Minqin Lai³, Feng Wang⁴, Xiaoyuan Liu⁴, Lihua Yin⁵

Affiliations

¹ The First Clinical Medical College, Lanzhou University, Lanzhou,730000, China; School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China. Electronic address: qinzsh21@lzu.edu.cn.
² School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China. Electronic address: huzh2021@lzu.edu.cn.
³ School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China. Electronic address: 220220929170@lzu.edu.cn.
⁴ School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China.
⁵ The First Clinical Medical College, Lanzhou University, Lanzhou,730000, China; School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China. Electronic address: yinlh@lzu.edu.cn.

PMID: 36781109
DOI: 10.1016/j.jormas.2023.101422

Abstract

Objective: Oral tongue keratinized squamous cell carcinoma (OTKSCC), a relatively rare form of tongue cancer (TC) in clinical practice, accompanied by features of cell keratosis, is an uncommon histological subtype. However, its specific clinicopathological features and prognosis have not been adequately described. In this study, we aimed to create a nomogram using R language software to predict overall survival (OS) of patients with OTKSCC to assess the prognosis of OTKSCC patients.

Methods: We extracted clinical and related prognostic data of OTKSCC patients from 1975 to 2019 from the Surveillance, Epidemiology, and End Results database. Independent prognostic factors were selected using univariate and multivariate Cox analyses, and a nomogram was constructed using R software. The C-index, area under the curve (AUC) of receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA) were used to assess the clinical utility of the nomogram. Finally, OS was assessed using the Kaplan-Meier method.

Results: A total of 2450 OTKSCC patients were included in the study. Univariate and multivariate Cox regression analyses were used to identify age, T stage, N stage, surgery, and radiation therapy as independent risk factors (p<0.05). In the training cohort, the calibration index of the nomogram was 0.725, while the AUC values for nomogram, age, T stage, N stage, surgery and radiation therapy were 0.878, 0.639, 0.781, 0.661, 0.724 and 0.354, respectively. At the same time, in the verification queue, the calibration index of the nomogram was 0.726, while the AUC values for nomogram, age, T stage, N stage, surgery and radiation therapy were 0.859,0.612,0.826,0.675,0.758 and 0.303, respectively. Ideal uniformity of the models from the training and validation cohorts was demonstrated in the calibration and DCA curves. Univariate survival analysis showed that age, T stage, N stage, surgery, and radiotherapy were statistically significant for prognosis (p<0.05).

Conclusion: Age, T stage, N stage, surgery, and radiation therapy are independently associated with the OS, and the established nomogram is an effective visualization tool for predicting the OS of OTKSCC patients.

Keywords: Nomogram; Oral tongue keratinized squamous cell carcinoma; Overall survival; Prognosis; SEER database.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Squamous Cell* / diagnosis
Carcinoma, Squamous Cell* / epidemiology
Carcinoma, Squamous Cell* / therapy
Head and Neck Neoplasms*
Humans
Nomograms
Squamous Cell Carcinoma of Head and Neck
Tongue