1. A novel prognostic model predicts overall survival in patients with nasopharyngeal carcinoma based on clinical features and blood biomarkers
- Author
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Changchun Lai, Hanqing Huang, Hualiang Lv, Hao Chen, Chunning Zhang, Xia Ke, Lei Zhou, Chuchan Zhou, and Shulin Chen
- Subjects
0301 basic medicine ,Oncology ,Male ,Cancer Research ,Herpesvirus 4, Human ,Kaplan-Meier Estimate ,Cohort Studies ,0302 clinical medicine ,RC254-282 ,Original Research ,Framingham Risk Score ,lasso regression ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Middle Aged ,Prognosis ,030220 oncology & carcinogenesis ,Regression Analysis ,Female ,medicine.medical_specialty ,DNA Copy Number Variations ,TNM staging system ,Decision Support Techniques ,nomogram ,03 medical and health sciences ,Lasso regression ,Internal medicine ,medicine ,Overall survival ,Biomarkers, Tumor ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Staging ,Retrospective Studies ,Models, Statistical ,model ,business.industry ,nasopharyngeal carcinoma ,Clinical Cancer Research ,Nasopharyngeal Neoplasms ,Nomogram ,medicine.disease ,Nomograms ,030104 developmental biology ,Nasopharyngeal carcinoma ,Blood biomarkers ,DNA, Viral ,Prognostic model ,business ,prognostic - Abstract
This study aims to develop and validate a novel prognostic model to estimate overall survival (OS) in nasopharyngeal carcinoma (NPC) patients based on clinical features and blood biomarkers. We assessed the model's incremental value to the TNM staging system, clinical treatment, and Epstein‐Barr virus (EBV) DNA copy number for individual OS estimation. We retrospectively analyzed 519 consecutive patients with NPC. A prognostic model was generated using the Lasso regression model in the training cohort. Then we compared the predictive accuracy of the novel prognostic model with TNM staging, clinical treatment, and EBV DNA copy number using concordance index (C‐index), time‐dependent ROC (tdROC), and decision curve analysis (DCA). Subsequently, we built a nomogram for OS incorporating the prognostic model, TNM staging, and clinical treatment. Finally, we stratified patients into high‐risk and low‐risk groups according to the model risk score, and we analyzed the survival time of these two groups using Kaplan–Meier survival plots. All results were validated in the independent validation cohort. Using the Lasso regression, we established a prognostic model consisting of 13 variables with respect to patient prognosis. The C‐index, tdROC, and DCA showed that the prognostic model had good predictive accuracy and discriminatory power in the training cohort than did TNM staging, clinical treatment, and EBV DNA copy number. Nomogram consisting of the prognostic model, TNM staging, clinical treatment, and EBV DNA copy number showed some superior net benefit. Based on the model risk score, we split the patients into two subgroups: low‐risk (risk score ≤ −1.423) and high‐risk (risk score > −1.423). There were significant differences in OS between the two subgroups of patients. Similar results were observed in the validation cohort. The proposed novel prognostic model based on clinical features and serological markers may represent a promising tool for estimating OS in NPC patients., 1. Currently, the TNM staging system is not adequate for prognosis without considering other clinicopathological factors or serum biomarkers. 2. In this study, we adopt a new algorithm to establish a novel prognostic model based on clinical features and blood biomarkers, which showed better predictive accuracy than traditional TNM staging, clinical treatment, and EBV DNA. 3. The prognostic model represents a promising signature for estimating OS in NPC patients.
- Published
- 2021