Clinical Study
Aishan·Yilihamu, Keranmu·Abasi, WEI Yiru, XUJun
《Journal of Oral and Maxillofacial Surgery》.
Accepted: 2025-05-16
Objective: To construct a survival prognosis prediction model based on gingival carcinoma patient data from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute in the United States, and evaluate its effectiveness. Methods: Download relevant basic information, clinical information, and follow-up data of patients diagnosed with gingival carcinoma between 2004 and 2018 from the SEER database, and randomly divide the patients into a modeling group (70%) and a validation group (30%). Through univariate and multivariate Cox regression analysis, variables were screened to determine independent prognostic risk factors for gingival carcinoma patients, and a nomogram was constructed. Evaluate the prediction model from three perspectives: discrimination, calibration, and clinical applicability. X-Tile software was used for risk stratification of the gingival carcinoma patients. Results: This study included 3334 patients with gingival carcinoma, with 3-year, 5-year, and 10-year survival rates of 59.03%, 48.89%, and 30.69%, respectively. The concordance index (C-index) of the modeling group and validation group were 0.715 and the 0.716, respectively; The receiver operating characteristic (ROC) curve results showed that the area under the curve (AUC) for predicting the 3-year, 5-year, and 10-year overall survival rates of gingival carcinoma patients in the modeling group were 0.757, 0.759, and 0.771, respectively. In the validation group, they were 0.747, 0.765, and 0.784, respectively. The C-index and AUC of the nomogram were higher than those of the traditional TNM staging system (P<0.001). The calibration curve results indicate that the nomogram model has good predictive accuracy. The decision curve analysis (DCA) results show that the nomogram has good clinical application value and is superior to the traditional TNM staging system.Patients were divided into low-risk group (<116.47), medium-risk group (116.47-213.24), and high-risk group (≥213.24) based on the cutoff value of the total score in the nomogram. There was a statistically significant difference in survival rate among the three groups (P<0.001). Conclusion: Age, marital status, histological grading, T stage, N stage, surgical status, and radiotherapy status are factors affecting the survival of patients with gingival carcinoma. The nomogram prediction model constructed in this study can provide reference for predicting the prognosis of gingival carcinoma patients.