Development of a Nomogram for Predicting Overall Survival of Oral and Oropharyngeal Squamous Cell Carcinoma

Abstract

This study aimed to examine the correlation between Ki-67 expression and clinicopathological features of oral and oropharyngeal squamous cell carcinoma (OSCC/OPSCC), evaluate the prognostic value of Ki-67, and develop a prognostic model incorporating Ki-67 expression. A total of 469 patients diagnosed with OSCC/OPSCC, hospitalized between 2012 and 2022, were included. Patients’ surgical specimens were subjected to immunohistochemical staining to determine their Ki-67 expression. Clinicopathological data of patients were also collected. Patients exhibiting male sex, poor pathological differentiation, advanced TNM stage, and metastasis demonstrated elevated levels of Ki-67 expression. Age and recurrence did not affect that. According to the Cox proportional hazards model, Ki-67, age, recurrence, metastasis, and primary tumor site were identified as independent risk factors for patient prognosis. Kaplan–Meier survival analysis indicated that the higher the Ki-67 expression, the shorter the patients’ overall survival. A prognostic model using independent risk factors was developed. The model was presented as a nomogram with a c-index of 0.768. The calibration curve also showed a good predictive performance of the model. This study confirmed the prognostic significance of Ki-67 expression in OSCC/OPSCC. A prognostic prediction model that incorporated Ki-67 expression was developed, providing a new tool for predicting patient prognosis in clinical practice.