TY - JOUR
T1 - Nomogram Identifies Age as the Most Important Predictor of Overall Survival in Oral Cavity Squamous Cell Cancer After Primary Surgery
AU - Gupta, Supriya
AU - Waller, Jennifer
AU - Brown, Jimmy J
AU - Elam, Yolanda
AU - Rawson, James V
AU - Pucar, Darko
N1 - Publisher Copyright:
© 2019, Association of Otolaryngologists of India.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Our goal was to determine the most important predictors and construct a nomogram for overall survival (OS) in oral cavity squamous cell cancer (OCSCC) treated with primary surgery followed by observation, adjuvant radiation or chemoradiation. Multivariable analysis was performed using Cox Proportional Hazard model of 9258 OCSCC patients from Surveillance, Epidemiology and End Results Program (SEER) database treated with surgery from 2003 to 2009. Potential predictors of OS were age, gender, race, tobacco use, oral cancer sub-sites, pathologic tumor stage and grade, pathologic nodal stage, extra-capsular invasion, clinical levels IV and V involvement, and adjuvant treatment selection. Weighted propensity scores for treatment were used to balance observed baseline characteristics between three treatment groups in order to reduce bias. Following primary surgery, patients underwent observation (56%), radiation alone (31%) or chemoradiation (13%). All tested predictors were statistically significant and included in our final nomogram. Most important predictor of OS was age, followed by pathologic tumor stage. SEER based-survival nomogram for OCSCC patients differs from published models derived from patients treated in a single or few academic treatment centers. An unexpected finding of patient age being the best OS predictor suggests that this factor may be more critical for the outcome than previously anticipated.
AB - Our goal was to determine the most important predictors and construct a nomogram for overall survival (OS) in oral cavity squamous cell cancer (OCSCC) treated with primary surgery followed by observation, adjuvant radiation or chemoradiation. Multivariable analysis was performed using Cox Proportional Hazard model of 9258 OCSCC patients from Surveillance, Epidemiology and End Results Program (SEER) database treated with surgery from 2003 to 2009. Potential predictors of OS were age, gender, race, tobacco use, oral cancer sub-sites, pathologic tumor stage and grade, pathologic nodal stage, extra-capsular invasion, clinical levels IV and V involvement, and adjuvant treatment selection. Weighted propensity scores for treatment were used to balance observed baseline characteristics between three treatment groups in order to reduce bias. Following primary surgery, patients underwent observation (56%), radiation alone (31%) or chemoradiation (13%). All tested predictors were statistically significant and included in our final nomogram. Most important predictor of OS was age, followed by pathologic tumor stage. SEER based-survival nomogram for OCSCC patients differs from published models derived from patients treated in a single or few academic treatment centers. An unexpected finding of patient age being the best OS predictor suggests that this factor may be more critical for the outcome than previously anticipated.
KW - Age
KW - Nomogram
KW - Oral cavity
KW - Squamous cell cancer
KW - Survival
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UR - http://www.scopus.com/inward/citedby.url?scp=85070995013&partnerID=8YFLogxK
U2 - 10.1007/s12070-019-01726-7
DO - 10.1007/s12070-019-01726-7
M3 - Article
AN - SCOPUS:85070995013
SN - 2231-3796
VL - 72
SP - 160
EP - 168
JO - Indian Journal of Otolaryngology and Head and Neck Surgery
JF - Indian Journal of Otolaryngology and Head and Neck Surgery
IS - 2
ER -