J Cancer 2017; 8(12):2247-2255. doi:10.7150/jca.19461

Research Paper

Develop and validation a nomogram to predict the recurrent probability in patients with major salivary gland cancer

Chang-Hsien Lu1, Chien-Ting Liu2, Pei-Hung Chang3, Chia-Yen Hung4, Shau-Hsuan Li2, Ta-Sen Yeh5,6, Yung-Shin Hung4, Wen-Chi Chou4,6✉

1. Department of Hematology-Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan;
2. Department of Hematology-Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan;
3. Department of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan;
4. Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan;
5. Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan;
6. Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan.

Abstract

Objectives: Prediction of recurrent risk in patients with major salivary gland carcinoma (MSGC) after surgical treatment is an important but difficult task because of a broad spectrum of tumor histological subtypes and diverse clinical behaviors. This study aimed to develop and validate a nomogram to predict the recurrent probability in patients with MSGC.

Methods: A total of 231 consecutive patients with MSGC received curative-intend surgery between 2002 and 2014 from one medical center were selected as the training set. Clinicopathologic variables with the most significant values in the multivariate Cox regression were selected to build into a nomogram to estimate the recurrence probability. An independent validation set of 139 patients treated at the same period from 3 other hospitals were selected for external validation and calibration.

Results: The nomogram was developed on six significant predictive factors, including the smoking history, tumor grade, perineural invasion, lymphatic invasion, pathologic T- and N-classification, of tumor recurrence retained in the multivariate Cox model. The nomogram had a highly predictive performance, with a bootstrapped corrected concordance index of 0.82 for the training set and 0.78 for the validation set. The nomogram showed good calibration in predict 2-year and 5-year recurrence probability both in the training and validation set.

Conclusions: We developed and externally validated an accurate nomogram for prediction the tumor recurrence probability of patients with MSGC after surgical treatment. This nomogram may be used to assist clinician and patient in elaborating the recurrent risk and making decision for appropriate adjuvant treatment.

Keywords: major salivary gland cancer, recurrence, nomogram, validation, calibration

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How to cite this article:
Lu CH, Liu CT, Chang PH, Hung CY, Li SH, Yeh TS, Hung YS, Chou WC. Develop and validation a nomogram to predict the recurrent probability in patients with major salivary gland cancer. J Cancer 2017; 8(12):2247-2255. doi:10.7150/jca.19461. Available from http://www.jcancer.org/v08p2247.htm