Nomograms predicting overall survival and cancer-specific survival in patients with squamous cell carcinoma based on the Surveillance, Epidemiology, and End Results (SEER) database
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Squamous cell carcinoma (SCC) is one of the most common types of malignant tumors worldwide, with a high incidence and a certain mortality. At present, there is a lack of sufficient research on the factors influencing the prognosis of SCC. This study aimed to develop prognostic nomograms for overall survival (OS) and cancer-specific survival (CSS) in a heterogeneous, nonmetastatics SCC population and to evaluate their internal performance. Methods: Data for this retrospective cohort study were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for 2010-2017. Patients aged 15-89 years with pathologically confirmed SCC [International Classification of Diseases for Oncology, Third Edition (ICD-O-3) histology codes 8070-8078] and harmonized M0 disease were included after excluding distant Summary Stage, recorded organ metastases, and unknown or unmappable tumor (T) or node (N) categories. The cohort was split 70:30 into training and internal validation sets. Multivariable Cox models incorporated age using restricted cubic splines, and performance was assessed using Harrell's C-index and calibration at 1, 3, and 5 years. Results: A total of 84,208 patients were included, comprising lung and bronchus SCC (n=34,798; 41.3%), head and neck SCC (n=26,166; 31.1%), anal/anorectal SCC (n=6,177; 7.3%), esophageal SCC (n=2,976; 3.5%), and other anatomical sites (n=14,091; 16.7%); no cutaneous SCC was included. The training and validation cohorts contained 58,944 and 25,264 patients, respectively. In the validation cohort, the C-index was 0.720 [95% confidence interval (CI): 0.716-0.724] for OS and 0.738 (95% CI: 0.733-0.743) for CSS. Calibration slopes were 1.016 (95% CI: 0.995-1.037) for OS and 1.006 (95% CI: 0.982-1.031) for CSS, with modest local deviations. Global proportional hazards tests were significant for both endpoints. Conclusions: The revised nomograms showed moderate discrimination and close overall internal calibration in a nonmetastatic SCC cohort. They should be considered hypothesis-generating prognostic tools that require prospective and external validation before routine clinical use.
Source: Translational Cancer Research
Authors: Ying Peng, Zhixiong Chen
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224104935