Related Experiment Video
Updated: Mar 31, 2026
Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Establishment and Validation of Prognostic Nomograms for Endemic Nasopharyngeal Carcinoma
Lin-Quan Tang1, Chao-Feng Li1, Jing Li1
1: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (LQT, CFL, JL, WHC, QYC, LZ, SSG, LTL, LG, YSW, DHL, PYH, HYM, YQX, RS, MYC, YJH, XL, LW, CZ, KJC, CNQ, XG, YXZ, HQM, MSZ), Department of Nasopharyngeal Carcinoma (LQT, QYC, LZ, SSG, LTL, LG, YSW, DHL, PYH, HYM, YQX, RS, MYC, YJH, XL, LW, CZ, KJC, CNQ, XG, HQM), Department of Information Technology (CFL), Department of Medical Statistics and Epidemiology, the School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (LXY); ZhongShan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China (XPL, YH, YXXX, DPH, SHW, YTP).
Background:
This study aimed to establish an effective prognostic nomogram with or without plasma Epstein-Barr virus DNA (EBV DNA) for nondisseminated nasopharyngeal carcinoma (NPC).
Methods:
The nomogram was based on a retrospective study of 4630 patients who underwent radiotherapy with or without chemotherapy at Sun Yat-sen University Cancer Center from 2007 to 2009. The predictive accuracy and discriminative ability of the nomogram were determined by a concordance index (C-index) and calibration curve and were compared with EBV DNA and the current staging system. The results were validated using bootstrap resampling and a prospective cohort study on 1819 patients consecutively enrolled from 2011 to 2012 at the same institution. All statistical tests were two-sided.
Results:
Independent factors derived from multivariable analysis of the primary cohort to predict recurrence were age, sex, body mass index (BMI), T stage, N stage, plasma EBV DNA, pretreatment high sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), and hemoglobin level (HGB), which were all assembled into the nomogram with (nomogram B) or without EBV DNA (nomogram A). The calibration curve for the probability of recurrence showed that the nomogram-based predictions were in good agreement with actual observations. The C-index of nomogram B for predicting recurrence was 0.728 (P < .001), which was statistically higher than the C-index values for nomogram A (0.690), EBV DNA (0.680), and the current staging system (0.609). The C-index of nomogram B (0.730) and nomogram A (0.681) remained higher for predicting recurrence among patients treated with intensity-modulated radiotherapy (P < .001). The results were confirmed in the validation cohort.
Conclusions:
The proposed nomogram with or without plasma EBV DNA resulted in more accurate prognostic prediction for NPC patients.
More Related Videos
07:13Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
