Nomograms for predicting overall survival and progress-free survival in postoperative lip squamous cell carcinoma patients

Abstract

Abstract Background To obtain an individualized prediction of lip squamous cell carcinoma (LSCC) is essential. This study aimed to create predictive models to predict the prognosis of postoperative LSCC patients. Methods A total of 136 postoperative LSCC patients diagnosed between June 2012 and June 2018 were enrolled from two medical institutions and randomly divided into the training and validation groups at a ratio of 7:3. According to the results of the univariate and multivariate Cox regression analyses, two nomograms were established to predict the overall survival (OS) and progression-free survival (PFS) of postoperative LSCC patients. Results The univariate and multivariate Cox regression analysis showed that higher pathological grade, age ≥ 70 years, higher T-stage, positive lymph node metastasis (LNM), perineural invasion (PNI), vascular invasion (VI), and positive surgical margin were independent predictors of inferior OS. Meanwhile, higher pathological grade, age ≥ 70 years, higher T-stage, LNM, PNI, and positive surgical margin were independent predictors of inferior PFS. Based on the results above, two nomograms were constructed to predict 3- and 5-year OS and PFS in patients with LSCC. The C-indexes of the OS and PFS nomograms were 0.865 and 0.801 in the training group, and 0.915 and 0.815 in the validation group. The calibration curves showed satisfactory consistency between predicted and actual observed survival rates. The outperformance of the nomogram compared with the other predictors involved was shown by the decision curve analysis (DCA). Kaplan-Meier curves revealed statistical discrimination for the high-, medium-, and low-risk groups. Conclusion This retrospective study established and validated two nomograms for predicting OS and PFS in patients with postoperative LSCC, which has a good clinical individualized application value.