Nomogram for the prediction of primary distant metastasis of nasopharyngeal carcinoma to guide individualized application of FDG PET/CT.

Purpose: This study aimed to establish an effective nomogram to predict primary distant metastasis (DM) in patients with nasopharyngeal carcinoma (NPC) to guide the application of PET/CT. Methods: In total, 3591 patients with pathologically confirmed NPC were consecutively enrolled. The nomogram was...

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Published in:European Journal of Nuclear Medicine & Molecular Imaging Vol. 48; no. 8; pp. 2586 - 2599
Main Authors: Xiao, Bei-Bei, Lin, Da-Feng, Sun, Xue-Song, Zhang, Xu, Guo, Shan-Shan, Liu, Li-Ting, Luo, Dong-hua, Sun, Rui, Wen, Yue-Feng, Li, Ji-Bin, Lv, Xiao-Fei, Han, Lu-Jun, Yuan, Li, Liu, Sai-Lan, Tang, Qing-Nan, Liang, Yu-Jing, Li, Xiao-Yun, Guo, Ling, Chen, Qiu-Yan, Fan, Wei
Format: Journal Article
Published: Springer Nature Jul2021
Online Access:View this record in EBSCOhost
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        16197070
        NPC
      jtl: European Journal of Nuclear Medicine & Molecular Imaging
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      dt: Jul2021
      vid: 48
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      pub: Springer Nature
      place: New York, New York
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        148008075
        10.1007/s00259-020-05128-8
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        atl: Nomogram for the prediction of primary distant metastasis of nasopharyngeal carcinoma to guide individualized application of FDG PET/CT.
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        au:
          Xiao, Bei-Bei
          Lin, Da-Feng
          Sun, Xue-Song
          Zhang, Xu
          Guo, Shan-Shan
          Liu, Li-Ting
          Luo, Dong-hua
          Sun, Rui
          Wen, Yue-Feng
          Li, Ji-Bin
          Lv, Xiao-Fei
          Han, Lu-Jun
          Yuan, Li
          Liu, Sai-Lan
          Tang, Qing-Nan
          Liang, Yu-Jing
          Li, Xiao-Yun
          Guo, Ling
          Chen, Qiu-Yan
          Fan, Wei
        affil: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
      sug:
      ab: Purpose: This study aimed to establish an effective nomogram to predict primary distant metastasis (DM) in patients with nasopharyngeal carcinoma (NPC) to guide the application of PET/CT. Methods: In total, 3591 patients with pathologically confirmed NPC were consecutively enrolled. The nomogram was constructed based on 1922 patients treated between 2007 and 2014. Multivariate logistical regression was applied to identify the independent risk factors of DM. The predictive value of the nomogram was evaluated using the concordance index (C-index), calibration curve, probability density functions (PDFs), and clinical utility curve (CUC). The results were validated in 1669 patients enrolled from 2015 to 2016. Net reclassification improvement (NRI) was applied to compare performances of the nomogram with other clinical factors. The best cut-off value of the nomogram chosen for clinical application was analyzed. Results: A total of 355 patients showed primary DM among 3591 patients, yielding an incidence rate of 9.9%. Sex, N stage, EBV DNA level, lactate dehydrogenase level, and hemoglobin level were independent predictive factors for primary DM. C-indices in the training and validation cohort were 0.796 (95% CI, 0.76–0.83) and 0.779 (95% CI, 0.74–0.81), respectively. The NRI indices demonstrated that this model had better predictive performance than plasma EBV DNA level and N stage. We advocate for a threshold probability of 3.5% for guiding the application of PET/CT depending on the clinical utility analyses. Conclusion: This nomogram is a useful tool to predict primary DM of NPC and guide the clinical application of PET/CT individually at the initial staging.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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