Analysis of Prognostic Factors of Nasopharyngeal Carcinoma and Construction of Risk Nomogram Prediction Model

Abstract Objective To analyze the factors affecting the prognosis of nasopharyngeal carcinoma (NPC) patients and establish a risk nomogram prediction model for the diagnosis, treatment and prognosis of NPC. Methods A total of 1645 NPC patients (1470 survival) from 1973 to 2015 in the SEER database were included. The clinicopathological data of 180 NPC patients hospitalized in the First Affiliated Hospital of Bengbu Medical College since 2010 were collected. The spearman correlation analysis and COX regression analysis were used to identify the prognostic factors of NPC and establish the risk nomogram prediction model. Receiver operation characteristic (ROC) analysis and area under curves (AUC) were used to evaluate the ability of distinguishing the prognosis of NPC patients. The cross calibration was calculated to evaluate the external validation of established predictive model.Results The survival NPC had higher proportion in female, older age, degree of NPC differentiation, N and M stage (all P<0.05. The study factors including female, older age, and higher degree of differentiation were positively correlated with the prognosis of NPC patients (P<0.05), while N and M stage were negatively correlated with the prognosis of NPC patients (P<0.05). The factors including female (HR=4.92, 95%CI 3.58-6.75), age (HR=, 95%CI=), degree of differentiation (HR=, 95%CI=), N stage (HR=, 95%CI=) were independently associated with prognosis of NPC patients (P<0.05). Comparing with calibration curve, the constructed risk prediction model had good relations between predictive values and actual values (AUC=0.833). Additionally, the external verification results of 96 patients with NPC had a larger AUC in our established predictive model (AUC=0.851). Conclusions Female, degree of differentiation and N stage are independent factors for the prognosis of NPC patients. The risk nomogram prediction model has a good predictive ability for the survival of NPC patients, which can provide important insights into clinical prognosis for NPC patients.