Nomogram based on immune-inflammatory indicators and age-adjusted Charlson comorbidity index score to predict prognosis of postoperative parotid gland carcinoma patients

Nomogram based on immune-inflammatory indicators and age-adjusted Charlson comorbidity index score to predict prognosis of postoperative parotid gland carcinoma patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nomogram based on immune-inflammatory indicators and age-adjusted Charlson comorbidity index score to predict prognosis of postoperative parotid gland carcinoma patients Hao Cheng, Jin-Hong Xu, Jia-Qi He, Chen-Chen Wu, Jia-Fan Li, Xue-Lian Xu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3842935/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Parotid gland carcinoma (PGC) is a rare malignant tumor. The purpose of this study was to investigate the role of immune-inflammatory-nutrition indicators and age-adjusted Charlson comorbidity index score (ACCI) of PGC and develop the nomogram model for predicting prognosis. Method All patients diagnosed with PGC in two tertiary hospitals, treated with surgical resection, from March 2012 to June 2018 (n = 344) were obtained. Potential prognostic factors were identified by univariate and multivariate Cox regression analyses. The nomogram model was established based on these identified independent prognostic factors. The performance of the developed prognostic model was estimated by related indexes and plots. Result The study population consisted of 344 patients with PGC who underwent surgical resection, 285 patients without smoking (82.8%), and 225 patients (65.4%) with mucoepidermoid carcinoma, with a median age of 50.0 years. American Joint Committee on Cancer (AJCC) stage (p < 0.001), pathology (p = 0.019), tumor location (p < 0.001), extranodal extension (ENE) (p < 0.001), systemic immune-inflammation index (SII) (p = 0.004), prognostic nutrition index (PNI) (p = 0.003), ACCI (p < 0.001), and Glasgow prognostic Score (GPS) (p = 0.001) were independent indicators for disease free survival (DFS). Additionally, the independent prognostic factors for overall survival (OS) including AJCC stage (p = 0.015), pathology (p = 0.004), tumor location (p < 0.001), perineural invasion (p = 0.009), ENE (p < 0.001), systemic immune-inflammation index (SII) (p = 0.001), PNI (p = 0.001), ACCI (p = 0.003), and GPS (p = 0.033). The nomogram models for predicting DFS and OS in PGC patients were generated based on these independent risk factors. All nomogram models show good discriminative capability with area under curves (AUCs) over 0.8 (DFS 0.802, and OS 0.825, respectively). Decision curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification index (NRI) show good clinical net benefit of the two nomograms in both training and validation cohorts. Kaplan-Meier survival analyses showed superior discrimination of DFS and OS in the new risk stratification system compared with the AJCC stage system. Finally, postoperative patients with PGC who underwent adjuvant radiotherapy had a better prognosis in the high-, and medium-risk subgroups (p < 0.05), but not for the low-risk subgroup. Conclusion The immune-inflammatory-nutrition indicators and ACCI played an important role in both DFS and OS of PGC patients. Adjuvant radiotherapy had no benefit in the low-risk subgroup for PGC patients who underwent surgical resection. The newly established nomogram models perform well and can provide an individualized prognostic reference, which may be helpful for patients and surgeons in proper follow-up strategies. parotid gland carcinoma immune-inflammatory-nutrition indicators age-adjusted Charlson comorbidity index score prognosis nomogram Full Text Additional Declarations No competing interests reported. Supplementary Files tableS1.docx tableS2.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 28 Mar, 2024 Reviewers agreed at journal 29 Feb, 2024 Reviews received at journal 29 Feb, 2024 Reviewers agreed at journal 28 Feb, 2024 Reviewers invited by journal 02 Feb, 2024 Editor assigned by journal 28 Jan, 2024 Editor invited by journal 14 Jan, 2024 Submission checks completed at journal 14 Jan, 2024 First submitted to journal 07 Jan, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3842935","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":266960370,"identity":"5854e43a-fdf7-4602-9320-c743c7ded81a","order_by":0,"name":"Hao Cheng","email":"","orcid":"","institution":"The First Affiliated Hospital of Xinxiang Medical University","correspondingAuthor":false,"prefix":"","firstName":"Hao","middleName":"","lastName":"Cheng","suffix":""},{"id":266960371,"identity":"9ca07c30-41fd-4453-9164-8b1586a22131","order_by":1,"name":"Jin-Hong Xu","email":"","orcid":"","institution":"AnYang District 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patients","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"parotid gland carcinoma, immune-inflammatory-nutrition indicators, age-adjusted Charlson comorbidity index score, prognosis, nomogram","lastPublishedDoi":"10.21203/rs.3.rs-3842935/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3842935/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eParotid gland carcinoma (PGC) is a rare malignant tumor. The purpose of this study was to investigate the role of immune-inflammatory-nutrition indicators and age-adjusted Charlson comorbidity index score (ACCI) of PGC and develop the nomogram model for predicting prognosis.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eAll patients diagnosed with PGC in two tertiary hospitals, treated with surgical resection, from March 2012 to June 2018 (n\u0026thinsp;=\u0026thinsp;344) were obtained. Potential prognostic factors were identified by univariate and multivariate Cox regression analyses. The nomogram model was established based on these identified independent prognostic factors. The performance of the developed prognostic model was estimated by related indexes and plots.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eThe study population consisted of 344 patients with PGC who underwent surgical resection, 285 patients without smoking (82.8%), and 225 patients (65.4%) with mucoepidermoid carcinoma, with a median age of 50.0 years. American Joint Committee on Cancer (AJCC) stage (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), pathology (p\u0026thinsp;=\u0026thinsp;0.019), tumor location (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), extranodal extension (ENE) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), systemic immune-inflammation index (SII) (p\u0026thinsp;=\u0026thinsp;0.004), prognostic nutrition index (PNI) (p\u0026thinsp;=\u0026thinsp;0.003), ACCI (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and Glasgow prognostic Score (GPS) (p\u0026thinsp;=\u0026thinsp;0.001) were independent indicators for disease free survival (DFS). Additionally, the independent prognostic factors for overall survival (OS) including AJCC stage (p\u0026thinsp;=\u0026thinsp;0.015), pathology (p\u0026thinsp;=\u0026thinsp;0.004), tumor location (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), perineural invasion (p\u0026thinsp;=\u0026thinsp;0.009), ENE (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), systemic immune-inflammation index (SII) (p\u0026thinsp;=\u0026thinsp;0.001), PNI (p\u0026thinsp;=\u0026thinsp;0.001), ACCI (p\u0026thinsp;=\u0026thinsp;0.003), and GPS (p\u0026thinsp;=\u0026thinsp;0.033). The nomogram models for predicting DFS and OS in PGC patients were generated based on these independent risk factors. All nomogram models show good discriminative capability with area under curves (AUCs) over 0.8 (DFS 0.802, and OS 0.825, respectively). Decision curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification index (NRI) show good clinical net benefit of the two nomograms in both training and validation cohorts. Kaplan-Meier survival analyses showed superior discrimination of DFS and OS in the new risk stratification system compared with the AJCC stage system. Finally, postoperative patients with PGC who underwent adjuvant radiotherapy had a better prognosis in the high-, and medium-risk subgroups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), but not for the low-risk subgroup.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe immune-inflammatory-nutrition indicators and ACCI played an important role in both DFS and OS of PGC patients. Adjuvant radiotherapy had no benefit in the low-risk subgroup for PGC patients who underwent surgical resection. The newly established nomogram models perform well and can provide an individualized prognostic reference, which may be helpful for patients and surgeons in proper follow-up strategies.\u003c/p\u003e","manuscriptTitle":"Nomogram based on immune-inflammatory indicators and age-adjusted Charlson comorbidity index score to predict prognosis of postoperative parotid gland carcinoma patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-16 20:47:15","doi":"10.21203/rs.3.rs-3842935/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-03-28T04:19:01+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"1c7befb2-08f7-4993-ba57-0b8ff2a622b6","date":"2024-02-29T08:24:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-02-29T06:02:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"905ec756-61e5-410f-a564-e91d57cccfed_SNPRID","date":"2024-02-29T03:43:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-02T16:03:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-01-28T15:58:17+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-01-14T06:04:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-14T06:03:04+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2024-01-07T15:50:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"02ff05c2-7d18-4b0e-afff-ac3af7ffa009","owner":[],"postedDate":"January 16th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-06-17T04:55:39+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-16 20:47:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3842935","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3842935","identity":"rs-3842935","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}