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Peeperkorn S, Meulemans J, Van Lierde C, Laenen A, Valstar MH, Balm AJM, Delaere P, Vander Poorten V. Validated Prognostic Nomograms for Patients With Parotid Carcinoma Predicting 2- and 5-Year Tumor Recurrence-Free Interval Probability. Front Oncol 2020; 10:1535. [PMID: 32984008 PMCID: PMC7477337 DOI: 10.3389/fonc.2020.01535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/17/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Salivary gland malignancies are rare tumors with a heterogenous histological and clinical appearance. Previously, we identified multiple prognostic factors in patients with parotid cancer and developed prognostic indices which have repeatedly been validated internationally, demonstrating their general applicability and lasting relevance. Recently, nomograms gained popularity as a prognostic tool. Thus, in this research we aimed to construct nomograms based on our previous validated prognostic models. Material and Methods: Nomograms were constructed using the previously reported dataset of 168 patients with parotid cancer which was used to develop pre- and postoperative prognostic scores, PS1 and PS2, respectively. Concordance indices for PS1 and PS2 were previously estimated at 0.74 and 0.71, respectively, and are in line with other, widely accepted oncological nomograms. Results: Pre- and postoperative nomograms predicting 2- and 5-year tumor recurrence-free survival probability are presented. All previously multivariately identified and validated prognostic factors, are incorporated (T size, N classification, pain, age at diagnosis, skin invasion, facial nerve dysfunction, perineural growth, and positive surgical margins). Examples of clinical application and interpretation are given. Conclusions: The presented prognostic nomograms for predicting 2- and 5-year tumor recurrence-free probability in patients with parotid cancer are powerful, user-friendly, visual tools and are based on internationally validated prognostic indices. They allow for a reliable prognostic assessment and result in a more individualized estimate of the risk for recurrence than the prognostic grouping based on PS1 and PS2. This facilitates assigning trial-patients to risk groups, and may assist in therapeutic decision making and determining appropriate follow-up intervals in clinical practice.
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Affiliation(s)
- Sam Peeperkorn
- Otorhinolaryngology - Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jeroen Meulemans
- Otorhinolaryngology - Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Charlotte Van Lierde
- Otorhinolaryngology - Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Annouschka Laenen
- KU Leuven Department of Public Health and Primary Care, Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Leuven, Belgium
| | - Matthijs H Valstar
- Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - A J M Balm
- Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Pierre Delaere
- Otorhinolaryngology - Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology - Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
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