Institutionally Validated Nomogram Predicting Prognosis for Older Patients with Nonmetastatic Nasopharyngeal Carcinoma

Plain language summary It is well known that more than 80% of newly diagnosed NPC patients are nonmetastatic. Older adult patients with nonmetastatic nasopharyngeal carcinoma have a poor chance of survival relative to younger patients. With the world's aging population, the treatment of older adults with nonmetastatic NPC has attracted more attention from clinicians. The use of the American Joint Committee on Cancer staging system alone has significant shortcomings in predicting survival outcomes. Therefore, the authors developed a predictive tool by combining more prognostic factors with a specific multivariable statistical model, including age, tumor stage, node stage and treatment type, which is helpful for clinicians to more accurately evaluate the prognosis of patients. Aim: Older adult patients with nonmetastatic nasopharyngeal carcinoma (NPC) have poor outcomes relative to younger patients. The authors' group established a nomogram to predict the overall survival of older adults with NPC and inform patient management. Methods: Cases with NPC (n = 782) were enrolled in this study; clinical data in the Surveillance, Epidemiology, and End Results database from 2010 to 2015 served as the training cohort (n = 657), and patients from Jiangxi Cancer Hospital (n = 125) served as the external validation cohort. Results: Training and external validation cohort C-index, receiver operator characteristics curves and calibration curves showed that our nomogram has great predictive ability. Conclusions: Compared with tumor-node-metastasis staging, this nomogram can help clinicians better predict the prognosis of older adults with nonmetastatic NPC.