Annals of Surgical Oncology

, Volume 21, Issue 2, pp 637–642

Postoperative Nomograms Predictive of Survival After Surgical Management of Malignant Tumors of the Major Salivary Glands

  • Safina Ali
  • Frank L. Palmer
  • Changhong Yu
  • Monica DiLorenzo
  • Jatin P. Shah
  • Michael W. Kattan
  • Snehal G. Patel
  • Ian Ganly
Head and Neck Oncology

DOI: 10.1245/s10434-013-3321-y

Cite this article as:
Ali, S., Palmer, F.L., Yu, C. et al. Ann Surg Oncol (2014) 21: 637. doi:10.1245/s10434-013-3321-y

Abstract

Objectives

The objective of this study was to create a nomogram predictive of survival in salivary gland cancer.

Methods

Clinical, tumor, and treatment characteristics were collected for 301 patients who underwent surgery for salivary gland cancer between 1985 and 2009 at Memorial Sloan Kettering Cancer Centre. Factors predictive of overall survival (OS) and cancer-specific survival (CSS) were determined by univariate analysis. Cox risk regression was used to model OS data. Competing risks regression was used for cancer-specific death. Deaths from other causes were treated as competing risks for cancer-specific death. Predictive nomograms for OS and CSS were then created using stepdown method to select predictors of outcome.

Results

The median age was 62 (range 9–89) years. There were 156 (52 %) males and 145 (48 %) females. Five variables predictive for OS (age, clinical T4 stage, histological grade, perineural invasion, and tumor dimension) were used to generate a parsimonious model, and a nomogram was created to predict 10-year survival probability. The concordance index (CI) for this nomogram was 0.809. Five variables predictive for CSS (histological grade, perineural invasion, clinical T4 stage, positive nodal status, and status of margins) were used to generate a second nomogram predicting CSS. This nomogram had a CI of 0.856. Both nomograms were validated internally by assessing discrimination and calibration.

Conclusions

We have developed the first nomograms to predict prognosis in an individual patient with salivary gland cancer.

Supplementary material

10434_2013_3321_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 kb)
10434_2013_3321_MOESM2_ESM.tif (181 kb)
Supplemental Fig. 1Flowchart showing the categorization of 4381 patients with major salivary gland pathology treated at Memorial Sloan Kettering Cancer Center from 1985 to 2009. (TIFF 181 kb)
10434_2013_3321_MOESM3_ESM.tif (89 kb)
Supplemental Fig. 2Histological distribution of major salivary gland pathology treated at Memorial Sloan Kettering Cancer Center from 1985 to 2009 (TIFF 89 kb)
10434_2013_3321_MOESM4_ESM.jpg (52 kb)
Supplemental Fig. 3Calibration plot showing concordance index for cancer specific survival (JPEG 52 kb)

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Safina Ali
    • 1
  • Frank L. Palmer
    • 1
  • Changhong Yu
    • 2
  • Monica DiLorenzo
    • 1
  • Jatin P. Shah
    • 1
  • Michael W. Kattan
    • 2
  • Snehal G. Patel
    • 1
  • Ian Ganly
    • 1
  1. 1.Head and Neck Service, Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Quantitative Health SciencesThe Cleveland ClinicClevelandUSA