A Practical Online Dynamic Nomogram to Predict the Progression-Free Survival in Nasopharyngeal Carcinoma

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-07-17 DOI:10.1111/coa.70011

Jiayan Zhang, Jiayi Yu, Dan Zhang, Qian Liu, Qian Li, Zuhua Song, Bi Zhou, Zhuoyue Tang

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引用次数: 0

Abstract

Objective

This retrospective study aimed to establish a convenient and effective online dynamic nomogram for predicting progression-free survival (PFS) in nasopharyngeal carcinoma (NPC).

Methods

The clinical and imaging characteristics were retrospectively collected from 106 patients with pathologically confirmed NPC. Univariate and multivariate Cox proportional hazards regression analyses were performed to select the independent prognostic factors and construct a nomogram for predicting 1-, 3-, and 5-year PFS. The predictive effectiveness and clinical utility of the nomogram were evaluated by concordance index (C-index), calibration curves, and decision curve analysis (DCA). Patients were divided into different groups by risk score based on the nomogram, and the PFS rates of these two groups were compared by Kaplan–Meier curves.

Results

Univariate and multivariate analyses indicated that the ADC (OR 0.177, 95% CI 0.068–0.464), extranodal neoplastic spread (ENS) (OR 3.662, 95% CI 1.495–8.968), and lymphocyte-to-monocyte ratio (LMR) (OR 2.688, 95% CI 1.094–6.607) at baseline were independent prognostic factors of NPC, with all p < 0.05. The nomogram revealed favourable predictive performance (C-index = 0.795). The area under the receiver operating characteristic curve (AUC) of the nomogram for predicting 1-, 3-year, and 5-year PFS was 0.792, 0.849, and 0.822, respectively, which outperformed the AJCC 8th TNM staging system (AUC = 0.592, 0.543, and 0.575). Besides, the nomogram distinguished the PFS rates well between low-and high-risk groups (p < 0.0001).

Conclusion

The online dynamic nomogram based on ADC, ENS, and LMR can divide NPC patients into different risk groups, and its prediction efficiency is better than the TNM stage system.

Abstract Image

查看原文本刊更多论文

预测鼻咽癌无进展生存期的实用在线动态Nomogram。

目的：本回顾性研究旨在建立一种方便有效的预测鼻咽癌（NPC）无进展生存期（PFS）的在线动态图。方法：回顾性收集106例经病理证实的鼻咽癌患者的临床及影像学资料。进行单因素和多因素Cox比例风险回归分析，选择独立预后因素，构建预测1、3、5年PFS的nomogram。通过一致性指数（C-index）、校准曲线和决策曲线分析（DCA）评估nomogram的预测效果和临床应用价值。根据nomogram风险评分法将患者分为两组，采用Kaplan-Meier曲线比较两组患者的PFS率。结果：单因素和多因素分析显示，基线时ADC （OR 0.177, 95% CI 0.068 ~ 0.464）、结外肿瘤扩散（OR 3.662, 95% CI 1.495 ~ 8.968）、淋巴细胞/单核细胞比值（OR 2.688, 95% CI 1.094 ~ 6.607）是鼻咽癌的独立预后因素，且均为p。结论：基于ADC、ENS和LMR的在线动态nomogram将鼻咽癌患者划分为不同的危险组，其预测效果优于TNM分期系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.