Int J Biol Sci 2019; 15(7):1336-1344. doi:10.7150/ijbs.33329

Research Paper

Prognostic Score Predicts Survival in HPV-Negative Head and Neck Squamous Cell Cancer Patients

Xu Qian1,2,3*✉, Duc T. Nguyen4*, Yue Dong3, Branko Sinikovic5, Andreas M. Kaufmann6, Jeffrey N. Myers7, Andreas E. Albers2, Edward A. Graviss4

1. Division of Molecular Diagnostics, Department of Laboratory Medicine, Zhejiang Cancer Hospital, Hangzhou 310022, P.R. China
2. Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin 12200, Germany
3. Key Laboratory of Laboratory Medicine, Ministry of Education of China, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou 325035, P.R. China
4. Houston Methodist Research Institute, Houston 77030, United States
5. Department of Craniomaxillofacial, Oral and Plastic Surgery, Klinikum Ernst von Bergmann, Potsdam 14467, Germany
6. Clinic for Gynecology, Berlin Institute of Health, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin 12200, Germany
7. Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, United States
*Equal contribution

Abstract

Although patients having head and neck squamous cell carcinoma (HNSCC) have high mortality, standardized prognostic tools are unavailable. As such, having a validated simple prognostic scoring system to help predict mortality in these high-risk patients is urgently needed. The current study aimed to develop and internally validate a prognostic scoring system for overall mortality in human papillomavirus (HPV)-independent HNSCC patients. Data on 400 consecutive patients from the Cancer Genome Atlas database with a known HPV-RNA negative status were analyzed. A prognostic model to predict patient overall mortality was developed using the logistic regression beta coefficients and a simple risk score was created. The model was internally validated using bootstrap validation with 2000 replications. Five covariates (age, pT, pN, perineural invasion, and EAp53 score) were used in the development of the mortality risk score in the final model. Three risk groups were stratified based on the prognostic scores: low-risk (<96 points), medium-risk (96-121 points), and high-risk (≥122 points) with a survival of 76%, 62% and 35%, respectively. The proposed model presented good discrimination in both the development (AUC = 0.76; 95% CI 0.70, 0.81) and bootstrap validation (AUC = 0.76; 95% CI 0.70, 0.81) with a non-significant Hosmer-Lemeshow chi-square of 6.17 (p = 0.63). The proposed prognostic scoring system is easy to use to predict patient overall mortality and could also help in the appropriate allocation of medical resources while managing HNSCC patients. External validation (including re-calibration if needed) should be conducted to test the model's generalizability in different populations.

Keywords: head and neck cancer, EAp53, predictive model, survival, next generation sequencing

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How to cite this article:
Qian X, Nguyen DT, Dong Y, Sinikovic B, Kaufmann AM, Myers JN, Albers AE, Graviss EA. Prognostic Score Predicts Survival in HPV-Negative Head and Neck Squamous Cell Cancer Patients. Int J Biol Sci 2019; 15(7):1336-1344. doi:10.7150/ijbs.33329. Available from http://www.ijbs.com/v15p1336.htm