| Objective:To explore the relationship between clinicopathological features and cervical occult lymph node metastasis(OLNM)in patients with cN0 tongue squamous cell carcinoma(TSCC),and develop and validate a nomogram model of predicting the risk of cervical OLNM in cN0 TSCC.Methods:Clinical data of 230 patients with stage cN0 TSCC who underwent primary enlarged excision and neck lymph node dissection in the First Affiliated Hospital of Nanchang University and the Second Affiliated Hospital of Nanchang University between May 2008 and October 2016 were collected retrospectively.They were divided into a development cohort and a validation cohort at a 4:1 ratio.Logistic regression analysis was used to determine the risk factors of cervical lymph node metastasis in stage cN0 TSCC patients of the development cohort,and a nomogram was established to predict the risk of cervical lymph node metastasis in stage cN0 TSCC.In the validation cohort,the predictive performance and compliance of the model were evaluated by the consistency index(C-index)and calibration curve,and the clinical application value was evaluated by decision curve analysis(DCA).Results:Of the 230 patients,60 had cervical lymph node metastasis,with a positive rate of 26.1%.Multivariate analysis of the development cohort showed that location,growth pattern,tumor size and tumor pathological grade of the primary lesion were included in the prediction model.The predictive model was validated by the validation cohort,showing high consistency(C-index=0.846),good calibration and a high clinical value.Conclusion:The nomogram based on the location,growth pattern,tumor size and tumor pathological grade of the primary lesion could be used to predict the probability ofcervical occult lymph node metastasis before surgery in patients with TSCC of stage cN0.It could also be used as a reference tool for cervical lympn node dissection and a communication tool between the doctor and the patient. |
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