Nomogram for deciding adjuvant treatment after surgery for oral cavity squamous cell carcinoma

Background. The application of appropriate adjuvant treatment after surgery for oral cavity squamous cell carcinoma (OCSCC) is predicated on accurate patient risk stratification. Methods. A nomogram for estimating locoregional recurrence-free survival (LRFS) after treatment of OCSCC was constructed from a cohort of 590 patients with OCSCC who were treated at Memorial Sloan-Kettering Cancer Center (MSKCC). The nomogram was validated using a series of 417 patients with OCSCC who were treated at Hospital do Cancer AC Camargo (HACC) in So Paulo, Brazil. Results. Despite significant differences between the MSKCC and HACC cohorts, the nomogram was able to predict LRFS from OCSCC with a concordance index of 0.693. Further statistical analysis showed that the nomogram was well calibrated. Conclusions. This preliminary nomogram is the first prognostic model developed and externally validated to predict the likelihood of LRFS after treatment for an individual patient with OCSCC and may have practical utility for deciding adjuvant treatment. (C) 2008 Wiley Periodicals, Inc.