Predicting individualized mortality probabilities for patients with squamous cell carcinoma of the maxilla: Novel models with clinical and histopathological predictors

Head Neck. 2019 Oct;41(10):3584-3593. doi: 10.1002/hed.25879. Epub 2019 Jul 26.

Abstract

Background: The aim of this article was to develop prediction models that calculate postoperative 2- and 5-year mortality probabilities of patients with squamous cell carcinoma of the maxilla (MSCC).

Methods: Data were collected from the medical records of patients who had been operated between 2000 and 2015 for MSCC. Potential clinical and histopathological predictors were identified. Confounding-(un)adjusted multivariate Cox and logistic regression models were computed with stepwise backward selection. Internal validation was performed to assess calibration and discriminatory ability.

Results: Ninety-five patients with MSCC were included. Two-year follow-up was complete, and 85 patients had 5-year follow-up. Age, neck treatment, surgical margins, bone invasion, spindle growth, and vasoinvasive growth were associated with mortality. Models were adjusted for confounding with Charlson's comorbidities index. C-indexes were .841 and .770 respectively, and .838 and .749 after bootstrapping.

Conclusion: The MSCC-specific mortality probability can be calculated with new prediction models.

Keywords: head and neck cancer; maxillary squamous cell carcinoma; mortality; oral cancer; prediction model; prognosis; webcalculator.

MeSH terms

  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Cohort Studies
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Maxillary Neoplasms / mortality*
  • Maxillary Neoplasms / pathology*
  • Maxillary Neoplasms / surgery
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oral Surgical Procedures / methods
  • Predictive Value of Tests
  • Probability
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome