title: Development and validation of a nomogram for prediction of survival and local control in laryngeal carcinoma patients treated with radiotherapy alone: a cohort study based on 994 patients.
abstract: BACKGROUND
  To advise laryngeal carcinoma patients on the most appropriate form of treatment, a tool to predict survival and local control is needed.
  
  
  METHODS
  We performed a population-based cohort study on 994 laryngeal carcinoma patients, treated with RT from 1977 until 2008. Two nomograms were developed and validated. Performance of the models is expressed as the Area Under the Curve (AUC).
  
  
  RESULTS
  Unfavorable prognostic factors for overall survival were low hemoglobin level, male sex, high T-status, nodal involvement, older age, lower EQD(2T) (total radiation dose corrected for fraction dose and overall treatment time), and non-glottic tumor. All factors except tumor location were prognostic for local control. The AUCs were 0.73 for overall survival and 0.67 for local control. External validation of the survival model yielded AUCs of 0.68, 0.74, 0.76 and 0.71 for the Leuven (n=109), the VU Amsterdam (n=178), the Manchester (n=403) and the NKI cohort (n=205), respectively, while the validation procedure for the local control model resulted in AUCs of 0.70, 0.71, 0.72 and 0.62. The resulting nomograms were made available on the website www.predictcancer.org.
  
  
  CONCLUSIONS
  For patients with a laryngeal carcinoma treated with RT alone, we have developed visual, easy-to-use nomograms for the prediction of overall survival and primary local control. These models have been successfully validated in four external centers.
authors.affiliation: Department of Radiotherapy, Maastricht University Medical Centre +, The Netherlands.
authors.forename: Ada G T M
authors.initials: AG
authors.lastname: Egelmeer
authors.forename: E Rios
authors.initials: ER
authors.lastname: Velazquez
authors.forename: Jos M A
authors.initials: JM
authors.lastname: de Jong
authors.forename: Cary
authors.initials: C
authors.lastname: Oberije
authors.forename: Yasmyne
authors.initials: Y
authors.lastname: Geussens
authors.forename: Sandra
authors.initials: S
authors.lastname: Nuyts
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.forename: Derek
authors.initials: D
authors.lastname: Rietveld
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
authors.forename: Monique C
authors.initials: MC
authors.lastname: de Jong
authors.forename: Coen
authors.initials: C
authors.lastname: Rasch
authors.forename: Frank
authors.initials: F
authors.lastname: Hoebers
authors.forename: Jarrod
authors.initials: J
authors.lastname: Homer
authors.forename: Nick
authors.initials: N
authors.lastname: Slevin
authors.forename: Catharine
authors.initials: C
authors.lastname: West
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049451:Nomograms; D049268:Positron-Emission Tomography; D011379:Prognosis; D014057:Tomography, X-Ray Computed