Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer

J.F. Petersen, M.M. Stuiver, A.J. Timmermans, A. Chen, H. Zhang, J.P. O'Neill, S. Deady, V. Vander Poorten, J. Meulemans, J. Wennerberg, C. Skroder, A.T. Day, W. Koch, M.W.M. van den Brekel

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives/Hypothesis: TNM‐classification inadequately estimates patient‐specific overall survival (OS). We aimed to improve this by developing a risk‐prediction model for patients with advanced larynx cancer. Study Design: Cohort study. Methods: We developed a risk prediction model to estimate the 5‐year OS rate based on a cohort of 3,442 patients with T3T4N0N+M0 larynx cancer. The model was internally validated using bootstrapping samples and externally validated on patient data from five external centers (n = 770). The main outcome was performance of the model as tested by discrimination, calibration, and the ability to distinguish risk groups based on tertiles from the derivation dataset. The model performance was compared to a model based on T and N classification only. Results: We included age, gender, T and N classification, and subsite as prognostic variables in the standard model. After external validation, the standard model had a significantly better fit than a model based on T and N classification alone (C statistic, 0.59 vs. 0.55, P < .001). The model was able to distinguish well among three risk groups based on tertiles of the risk score. Adding treatment modality to the model did not decrease the predictive power. As a post hoc analysis, we tested the added value of comorbidity as scored by American Society of Anesthesiologists score in a subsample, which increased the C statistic to 0.68. Conclusions: A risk prediction model for patients with advanced larynx cancer, consisting of readily available clinical variables, gives more accurate estimations of the estimated 5‐year survival rate when compared to a model based on T and N classification alone.
Original languageEnglish
Pages (from-to)1140-1145
JournalThe Laryngoscope
Volume128
Issue number5
DOIs
Publication statusPublished - May 2018

Funding

The Netherlands Cancer Institute receives a research grant from ATOS Medical Sweden, which contributes to the existing infrastructure for health-related, quality-of-life research in the Department of Head and Neck Oncology and Surgery. The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry, as well as IKNL staff for scientific advice, and PALGA (the Dutch nationwide network and registry of histopathology and cytopathology) for their contribution to the national database on which the model was built.

FundersFunder number
Atos
IKNL
Netherlands Cancer Institute
Netherlands Cancer Registry
Netherlands Comprehensive Cancer Organisation
PALGA

    Fingerprint

    Dive into the research topics of 'Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer'. Together they form a unique fingerprint.

    Cite this