Construction and validation of a prognostic model for locally advanced laryngeal cancer surgery combined with postoperative radiotherapy
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Abstract
Objective To explore the risk factors of surgery combined with postoperative radiotherapy for the prognosis of patients with locally advanced laryngeal cancer, and to construct and validate a nomogram prediction model for prognosis. Methods A total of 206 patients who were admitted to Department of Radiotherapy, the Affiliated Hospital of Xuzhou Medical University from January 2016 to January 2020 were enrolled and their clinical data were retrospectively analyzed. The patients were randomly divided into a training set and a validation set (at a ratio of 7∶3). The optimal cut-off values of fibrinogen to albumin ratio (FAR) and systemic immune-inflammation index (SII) were determined in the training set. The independent risk factors were analyzed, and a nomogram based on FAR, SII, and other risk factors was constructed. Results In the training set, according to the receiver operating characteristics (ROC) curves, the optimal cut-off value of preoperative FAR and SII in predicting survival was 6.62 and 774, respectively. The final variables included in the model were the degree of tumor differentiation, lymph node metastasis, FAR, and SII (all P<0.05). The C-index of the training and validation sets for predicting overall survival was 0.878 and 0.836, respectively, and the area under the curve of the time-dependent ROC curve for predicting death was higher than 0.8. The calibration curves showed that the predictions were well fitted to the actual situation, and the clinical decision curves demonstrated that the majority of the patients achieved clinical benefits. Conclusions The nomogram based on FAR and SII can effectively predict the overall survival of patients with locally advanced laryngeal cancer.
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