TY - JOUR
T1 - Optimizing Survival Predictions of Hypopharynx Cancer
T2 - Development of a Clinical Prediction Model
AU - Arends, Coralie R.
AU - Petersen, Japke F.
AU - van der Noort, Vincent
AU - Timmermans, Adriana J.
AU - Leemans, C. René
AU - de Bree, Remco
AU - van den Brekel, Michiel W.M.
AU - Stuiver, Martijn M.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objectives: To develop and validate a clinical prediction model (CPM) for survival in hypopharynx cancer, thereby aiming to improve individualized estimations of survival. Methods: Retrospective cohort study of hypopharynx cancer patients. We randomly split the cohort into a derivation and validation dataset. The model was fitted on the derivation dataset and validated on the validation dataset. We used a Cox's proportional hazard model and least absolute shrinkage and selection operator (LASSO) selection. Performance (discrimination and calibration) of the CPM was tested. Results: The final model consisted of gender, subsite, TNM classification, Adult Comorbidity Evaluation-27 score (ACE27), body mass index (BMI), hemoglobin, albumin, and leukocyte count. Of these, TNM classification, ACE27, BMI, hemoglobin, and albumin had independent significant associations with survival. The C Statistic was 0.62 after validation. The model could significantly identify clinical risk groups. Conclusions: ACE27, BMI, hemoglobin, and albumin are independent predictors of overall survival. The identification of high-risk patients can be used in the counseling process and tailoring of treatment strategy or follow-up. Level of Evidence: 4 Laryngoscope, 130:2166–2172, 2020.
AB - Objectives: To develop and validate a clinical prediction model (CPM) for survival in hypopharynx cancer, thereby aiming to improve individualized estimations of survival. Methods: Retrospective cohort study of hypopharynx cancer patients. We randomly split the cohort into a derivation and validation dataset. The model was fitted on the derivation dataset and validated on the validation dataset. We used a Cox's proportional hazard model and least absolute shrinkage and selection operator (LASSO) selection. Performance (discrimination and calibration) of the CPM was tested. Results: The final model consisted of gender, subsite, TNM classification, Adult Comorbidity Evaluation-27 score (ACE27), body mass index (BMI), hemoglobin, albumin, and leukocyte count. Of these, TNM classification, ACE27, BMI, hemoglobin, and albumin had independent significant associations with survival. The C Statistic was 0.62 after validation. The model could significantly identify clinical risk groups. Conclusions: ACE27, BMI, hemoglobin, and albumin are independent predictors of overall survival. The identification of high-risk patients can be used in the counseling process and tailoring of treatment strategy or follow-up. Level of Evidence: 4 Laryngoscope, 130:2166–2172, 2020.
KW - chemoradiotherapy
KW - clinical prediction model
KW - Hypopharynx cancer
KW - LASSO
KW - survival
KW - total laryngectomy
UR - http://www.scopus.com/inward/record.url?scp=85074908802&partnerID=8YFLogxK
U2 - 10.1002/lary.28345
DO - 10.1002/lary.28345
M3 - Article
C2 - 31693181
AN - SCOPUS:85074908802
VL - 130
SP - 2166
EP - 2172
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 9
ER -