Skip to main content

Advertisement

SpringerLink
Log in

Prognostic nomograms based on immune scores for head–neck squamous cell carcinoma patients

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

We aim to develop an immune-score nomograms for predicting overall survival (OS) of patients with HNSCC and assess the association of immune scores with prognosis.

Methods

The data of 530 patients used in this study were retrieved from The Cancer Genome Atlas database. The optimization cut‐point for immune scores was expressed by X-tile 3.6.1 tool. Possible prognostic factors from univariate Cox analysis were further included in a multivariate Cox proportional hazards analysis to obtain significant risk factors. Prognostic nomograms were constructed based on the factors of significant multivariate prognostic using R version 3.5.1. A calibration map was generated by comparing the nomogram prediction probability and the observation for the 3-year and 5-year OS rates.

Results

We retrospectively analyzed 462 patients downloaded from TCGA dataset. Prognostic nomograms was integrated following risk factors of significant multivariate prognostic, such as age, angiolymphaic invasion (AI), perineura invasion(Per_invasion),tumor site, immune score, tumor-node-metastasis(TNM) stage. The concordance Index (C-index) for OS predictions was 0.723 (95% CI 0.671–0.785). Moreover, we compared the powerful efficiency of the nomograms with that of the TNM staging system. OS prediction determined on immune score set compared with the TNM staging with C-index = 0.723 vs 0.612. The calibration curves for the probability of OS of 3-year or 5-year showed no deviations between the prediction by nomograms and actual reference line.

Conclusion

The present study indicate that high and intermediate immune scores are as independent prognostic variables for OS of head–neck squamous cell carcinoma patients. We constructed novel nomograms may has the potential to provide individualized survival risk assessments and guide treatment decisions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability statement

The data used to support the findings of this study are included within the article.

Abbreviations

AI:

Angiolymphaic invasion

AJCC:

American Joint Committee on Cancer

C-index:

Concordance Index

HNSCC:

Head and neck squamous cell carcinoma

HPV:

Human papillomavirus

OS:

Overall survival

TNM:

Tumor-node-metastasis

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492

    Article  Google Scholar 

  2. Yom SS, Mallen-St Clair J, Ha PK (2017) Controversies in Postoperative Irradiation of Oropharyngeal Cancer After Transoral Surgery. Surg Oncol Clin N Am 26(3):357–370. https://doi.org/10.1016/j.soc.2017.01.006

    Article  PubMed  Google Scholar 

  3. Howard J, Dwivedi RC, Masterson L, Kothari P, Quon H, Holsinger FC (2018) De-intensified adjuvant (chemo)radiotherapy versus standard adjuvant chemoradiotherapy post transoral minimally invasive surgery for resectable HPV-positive oropharyngeal carcinoma. Cochrane Database Syst Rev 12:CD012939. https://doi.org/10.1002/14651858.cd012939.pub2

    Article  PubMed  Google Scholar 

  4. Bremnes RM, Busund LT, Kilvaer TL, Andersen S, Richardsen E, Paulsen EE, Hald S, Khanehkenari MR, Cooper WA, Kao SC, Donnem T (2016) The role of tumor-infiltrating lymphocytes in development, progression, and prognosis of non-small cell lung cancer. J Thoracic Oncol 11(6):789–800. https://doi.org/10.1016/j.jtho.2016.01.015

    Article  Google Scholar 

  5. Takada K, Kashiwagi S, Asano Y, Goto W, Takahashi K, Fujita H, Takashima T, Tomita S, Hirakawa K, Ohira M (2019) Clinical verification of the relationship between smoking and the immune microenvironment of breast cancer. J Transl Med 17(1):13

    Article  Google Scholar 

  6. Karpathiou G, Casteillo F, Giroult JB, Forest F, Fournel P, Monaya A, Froudarakis M, Dumollard JM, Prades JM, Peoc’H M (2017) Prognostic impact of immune microenvironment in laryngeal and pharyngeal squamous cell carcinoma: immune cell subtypes, immuno-suppressive pathways and clinicopathologic characteristics. Oncotarget 8(12):19310–19322

    Article  Google Scholar 

  7. Brierley J, Gospodarowicz M, O’Sulivan B (2016) The principles of cancer staging. Ecancermedicalscience 10:61

    Article  Google Scholar 

  8. Curry JM, Sprandio J, Cognetti D, Luginbuhl A, Bar-Ad V, Pribitkin E, Tuluc M (2014) Tumor microenvironment in head and neck squamous cell carcinoma. Semin Oncol 41(2):217–234

    Article  CAS  Google Scholar 

  9. Yitan Z, Peng Q, Yuan J (2014) TCGA-assembler: open-source software for retrieving and processing TCGA data. Nat Methods 11(6):599–600

    Article  Google Scholar 

  10. Moeckelmann N, Ebrahimi A, Dirven R, Liu J, Low TH, Gupta R, Ashford B, Ch’Ng S, Palme CE, Clark JR (2018) Analysis and comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal staging system in cutaneous and oral squamous cell cancer of the head and neck. Ann Surg Oncol 97(S 02):1730–1736

    Article  Google Scholar 

  11. Camp RL, Marisa DF, Rimm DL (2004) X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res 10(21):7252–7259

    Article  CAS  Google Scholar 

  12. Harrell FE Jr, Lee KL, Mark DB (1996) Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 15(4):361–387. https://doi.org/10.1002/(sici)1097-0258(19960229)15:4%3c361:aid-sim168%3e3.0.co;2-4

    Article  PubMed  Google Scholar 

  13. Mosquera SA, Ortueta Dd, Verma S (2018) The art of nomograms. Eye & Vision 5

  14. Lechner A, Schlößer HA, Thelen M, Wennhold K, Rothschild SI, Gilles R, Quaas A, Siefer OG, Huebbers CU, Cukuroglu E (2019) Tumor-associated B cells and humoral immune response in head and neck squamous cell carcinoma. OncoImmunology 8(3):1–14

    Article  Google Scholar 

  15. Yamaguchi K, Wu L, Caballero OL, Hibi K, Trink B, Resto V, Cairns P, Okami K, Koch WM, Sidransky D (2015) Frequent gain of the p40/p51/p63 gene locus in primary head and neck squamous cell carcinoma. Int J Cancer 86(5):684–689

    Article  Google Scholar 

  16. Rikimaru K, Tadokoro K, Yamamoto T, Enomoto S, Tsuchida N (2010) Gene amplification and overexpression of epidermal growth factor receptor in squamous cell carcinoma of the head and neck. Head Neck 14(1):8–13

    Article  Google Scholar 

  17. Kim KT, Kim BS, Ju HK (2016) Association between FAT1 mutation and overall survival in patients with human papillomavirus–negative head and neck squamous cell carcinoma. Head Neck 38(S1):E2021–E2029

    Article  Google Scholar 

  18. Weber A, Bellmann U, Bootz F, Wittekind C, Tannapfel A (2002) INK4a-ARF alterations and p53 mutations in primary and consecutive squamous cell carcinoma of the head and neck. Virchows Archiv Int J Pathol 441(2):133

    Article  CAS  Google Scholar 

  19. Sang HL, Do SI, Lee HJ, Kang HJ, Koo BS, Lim YC (2016) Notch1 signaling contributes to stemness in head and neck squamous cell carcinoma. Laboratory Investigation 96 (5)

  20. Lassen P, Eriksen JG, Hamilton-Dutoit S, Tramm T, Alsner J, Overgaard J (2009) Effect of HPV-associated p16INK4A expression on response to radiotherapy and survival in squamous cell carcinoma of the head and neck. J Clin Oncol Off J Am Soc Clin Oncol 27(12):1992

    Article  CAS  Google Scholar 

  21. Li JP, Zhang XM, Zhang Z, Zheng LH, Jindal S, Liu YJ (2019) Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma. Medicine 98(18):e15449

    Article  CAS  Google Scholar 

  22. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML (2008) Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 100(4):261–269

    Article  CAS  Google Scholar 

  23. Spector ME, Gallagher KK, Mchugh JB, Mukherji SK (2010) Correlation of radiographic and pathologic findings of dermal lymphatic invasion in head and neck squamous cell carcinoma. Laryngoscope 120(S3):S48

    Article  Google Scholar 

  24. Smith BD, Smith GL, Carter D, Sasaki CT, Haffty BG (2000) Prognostic significance of vascular endothelial growth factor protein levels in oral and oropharyngeal squamous cell carcinoma. J Clin Oncol 18(10):2046–2052

    Article  CAS  Google Scholar 

  25. Singh B, Bhaya M, Zimbler M, Stern J, Roland JT, Rosenfeld RM, Har-El G, Lucente FE (2015) Impact of comorbidity on outcome of young patients with head and neck squamous cell carcinoma. Head Neck 20(1):1–7

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank the efforts of the National Cancer Institute in the creation of the TCGA database.

Funding

No financial assistance was required for this study.

Author information

Author notes

  1. Wenfei Li and Kun Zhao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China

    Wenfei Li & Zhanqiu Wang

  2. Department of Otolaryngology, Head and Neck Surgery, First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China

    Kun Zhao

Authors
  1. Wenfei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kun Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhanqiu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

WL and ZW conceived and designed the study; WL collected the data. KZ and ZW analyzed the data. WL and KZ contributed to the writing of the manuscript.

Corresponding author

Correspondence to Zhanqiu Wang.

Ethics declarations

Conflict of interest

All author(s) indicated no potential conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, W., Zhao, K. & Wang, Z. Prognostic nomograms based on immune scores for head–neck squamous cell carcinoma patients. Eur Arch Otorhinolaryngol 278, 2493–2500 (2021). https://doi.org/10.1007/s00405-020-06358-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-06358-0

Keywords

Search

Navigation