Construction and Validation of a Clinical Model to Predict Lymph Node Metastasis in Early Hypopharyngeal Squamous Cell Carcinoma

Keshu Shan; Chunxia Zhu; Xueyou Lv; Jianing Yan; Qier Li

doi:10.71321/ggvee953

Authors

Keshu Shan The First Affiliated Hospital of Ningbo University
Chunxia Zhu The First Affiliated Hospital of Ningbo University
Xueyou Lv The First Affiliated Hospital of Ningbo University
Jianing Yan The First Affiliated Hospital of Ningbo University
Qier Li The First Affiliated Hospital of Ningbo University

DOI:

https://doi.org/10.71321/ggvee953

Keywords:

Metastasis, Hypopharyngeal, SEER, Nomogram, Prognosis

Abstract

Background: Hypopharyngeal squamous cell carcinoma (HSCC) is the most frequent histologic subtype of hypopharyngeal carcinoma and has a poor prognosis. With the development of upper gastrointestinal endoscopy, an increasing number of early HSCC cases can be diagnosed and treated by endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). However, clinicians lack an effective tool to predict lymph node metastasis (LNM) of early HSCC.

Methods: A total of 410 early HSCC cases were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Clinical data (50 early HSCC patients) from our hospital were applied for external validation. Univariate and multivariate logistic regression analyses to filter the risk factors were performed. A nomogram model was built to predict LNM in early HSCC patients according to the multivariate logistic regression model.

Results: HSCC patients with lymph node metastasis had worse overall survival rates and a higher risk of long-term mortality (P =0.016). The C-index and AUC of our predictive nomogram model were 0.674 and 0.623-0.726, respectively. The AUC, sensitivity, specificity, PPV, and NPV were 0.680 (95% CI: 0.525-0.835), 80.0%, 46.7%, 50.0%, and 77.8%, respectively, for the validation set.
Conclusion: Our study resulted in a novel nomogram model for predicting LNM that can be a promising tool for assessing the feasibility of EMR/ESD in early HSCC.

Impact: Our study provides a novel method for HSCC preoperative assessment before ESD.

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