Risk Factors and Nomogram Prediction Model for Recurrence After Low-Temperature Plasma Radiofrequency Ablation in Laryngeal Cancer Patients
Objective To explore the risk factors for recurrence in patients with laryngeal cancer after low-temperature plasma radiofrequency ablation,and to construct a Nomogram prediction model.Methods A retrospective analysis was conducted on the clinical data of 483 patients with laryngeal cancer who underwent low-temperature plasma radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2021.The patients were randomly divided into a modeling set(322 cases)and a validation set(161 cases)in a 2∶1 ratio.The risk factors of postoperative recurrence in laryngeal cancer patients undergoing low-temperature plasma radiofrequency ablation were analyzed using univariate and multivariate logistic regression analysis.The Nomogram prediction model was constructed using R software,and the predictive efficacy and clinical practicality of the model were evaluated using the receiver operating characteristic(ROC)curve,consistency index,calibration curve,and decision curve.Results The follow-up time of 483 patients with laryngeal cancer after low-temperature plasma radiofrequency ablation was 24-66 months,with a recurrence rate of 15.32％(74/483).There was no statistically significant difference in general data between the modeling set and the validation set(P＞0.05).The results of logistic regression analysis showed that T1b-T2 stage,low differentiation,tumor invasion before union and tumor invasion under the glottis were all risk factors for recurrence in laryngeal cancer patients after low-temperature plasma radiofrequency ablation(P＜0.05).The internal validation results of Bootstrap showed that the consistency indices of the Nomogram prediction model in the modeling set and validation set were 0.812(95％CI:0.797-0.838)and 0.805(95％CI:0.788-0.830),and the ROC curve showed that the area under the curve for predicting postoperative recurrence using the Nomogram prediction model in the modeling set and validation set was 0.795(95％CI:0.728-0.852)and 0.781(95％CI:0.713-0.839),indicating that the Nomogram prediction model had good discrimination.The calibration curve showed that the Nomogram prediction model fitted well with the actual postoperative recurrence probability in the modeling set and validation set.The decision curve showed that the Nomogram prediction model had good net benefits when the threshold probabilities were between 2％-99％and 9％-90％in the modeling set and validation set,respectively.Conclusion T1b-T2 stage,low differentiation,pre invasion union and tumor invasion subglottic are all risk factors for recurrence in laryngeal cancer patients after low-temperature plasma radiofrequency ablation.The Nomogram prediction model constructed based on the above four risk factors has good predictive efficacy and clinical practicality.
laryngeal cancerlow temperature plasma kniferadiofrequency ablationrecurrencerisk factorprediction model
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