Developing a predictive nomogram and web-based survival calculator for locally advanced hypopharyngeal cancer: A propensity score-adjusted, population-based study

Sihao Chen; Shanshan He; Dan Wang; Yi Liu; Shilong Shao; Li Tang; Chao Li; Qiuling Shi; Jifeng Liu; Feng Wang; Shichuan Zhang

doi:10.17305/bb.2023.8978

Authors

Sihao Chen Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China https://orcid.org/0000-0001-6401-9366
Shanshan He Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China https://orcid.org/0009-0001-9958-3327
Dan Wang Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China
Yi Liu Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China
Shilong Shao School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
Li Tang College of Public Health, Chongqing Medical University, Chongqing, China
Chao Li Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China
Qiuling Shi Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China; State Key Laboratory of Ultrasound in Medicine and Engineering, School of Public Health and Management, Chongqing Medical University, Chongqing, China
Jifeng Liu Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China; Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
Feng Wang Department of Medical Oncology, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
Shichuan Zhang Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China

DOI:

https://doi.org/10.17305/bb.2023.8978

Keywords:

Locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) , nomogram, survival, surgery-based therapy, Surveillance, Epidemiology, and End Results (SEER)

Abstract

Understanding the clinical features and accurately predicting the prognosis of patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) is important for patient centered decision-making. This study aimed to create a multi-factor nomogram predictive model and a web-based calculator to predict post-therapy survival for patients with LA-HPSCC. A retrospective cohort study analyzing Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 for patients diagnosed with LA-HPSCC was conducted and randomly divided into a training and a validation group (7:3 ratio). The external validation cohort included 276 patients from Sichuan Cancer Hospital, China. The Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression analysis was used to identify independent factors associated with overall survival (OS) and cancer-specific survival (CSS), and nomogram models and web-based survival calculators were constructed. Propensity score matching (PSM) was used to compare survival with different treatment options. A total of 2526 patients were included in the prognostic model. The median OS and CSS for the entire cohort were 20 (18.6-21.3) months and 24 (21.7-26.2) months, respectively. Nomogram models integrating the seven factors demonstrated high predictive accuracy for 3-year and 5-year survival. PSM found that patients who received surgery-based curative therapy had better OS and CSS than those who received radiotherapy-based treatment (median survival times: 33 months vs 18 months and 40 months vs 22 months, respectively). The nomogram model accurately predicted patient survival from LA-HPSCC. Surgery with adjuvant therapy yielded significantly better survival than definitive radiotherapy. and should be prioritized over definitive radiotherapy.