Predictive Nomogram for the Prediction of Recurrence of Cutaneous Squamous Cell Cancer

Aim: The prognosis of cutaneous squamous cell cancer (cSCC) individuals after curative resection is not satisfactory due to the recurrence with poor prognosis. We tried to identify the affecting clinical features of recurrence in cSCC patients. Methods: A total of 393 patients were retrospectively incorporated into our study. The χ test and logistic regression analysis were utilized to screen for the significant clinical indexes associated with the presence of cSCC recurrence. Recurrent nomogram was created based on the above informative clinical features to predict the probability of recurrence. The concordance index, area under curve (AUC), and calibration plots were used to assess the performance of the nomogram model and the NCCN Guidelines®. Moreover, the recurrent nomogram exhibited not only encouraging calibration ability, but also great clinical utility comparing with NCCN Guidelines®. Results: Of the 393 patients included in this study, 36 patients sufferred from recurrence. The multivariate analysis showed that exposure, tumor size, ulcer, precancerous lesions, and neural invasion at diagnosis were independent clinical factors affecting the prognosis of patients with cSCC. For the verification of results, the C-index was 0.818 respectively. The calibration curve also showed that the actual observation of recurrence was in good agreement with the prediction of the nomograms. Additionally, both DCA and CIC showed that the recurrent nomogram had good clinical application value. According to the score of each patient, the risk stratification system of cSCC patients was further established by perfectly dividing these patients into three groups, namely, low risk, medium risk, and high risk, in all queues. Conclusion: Exposure, tumor size, ulcer, precancerous lesions, and neural invasion were closely correlated with the presence of recurrence of cSCC patients. The recurrent nomogram held well predictive ability for the identification of cSCC patients with recurrence.