Abstract：
We explored the impact of stromal tumor-infiltrating lymphocytes (sTILs) on the prognostic value of an early death model for advanced buccal cancer. We assessed 121 patients with advanced buccal cancer who underwent primary tumor resection at a medical center. Predictors of early death and 5-year overall survival (OS) were analyzed using Cox regression models. Performance of models was evaluated with the Harrell C and Akaike information criterion. The net reclassification improvement of the early death model was also calculated relative to the 5-year OS model for one-year all-cause mortality. A total of 121 patients with advanced buccal cancer were recruited. Mean age was 56.1 ± 9.8 years; 117 (96.7%) patients were male. sTILs ≤30%, clinical nodal disease, pathological nodal disease, poor differentiation, lymphovascular invasion, perineural invasion, WPOI 5, and no adjuvant radiotherapy were risk factors for early death in univariate analysis. In multivariate analysis, clinical TNM, sTILs, clinical nodal disease, poor differentiation, lymphovascular invasion, and no adjuvant RT were independent factors for early death. sTILs, pathological nodal disease, poor differentiation, lymphovascular invasion, and no adjuvant RT were independent factors for early death in the multivariate model with pathological TNM. The discriminatory ability was better for early death model for 1-year all-cause mortality. Finally, incorporation of sTILs into the early death model increased net reclassification by 21% for the clinical TNM model and 28% for the pathological TNM model. Addition of sTILs improved the early death model, which may help physicians to identify high-risk patients for more intensive treatment and follow-up.
摘要：
我们探讨了间质瘤浸润淋巴细胞（sTIL）对晚期颊癌早期死亡模型预后价值的影响。我们评估了在医疗中心接受原发性肿瘤切除术的121例晚期颊癌患者。使用Cox回归模型分析早期死亡和5年总生存期（OS）的预测因素。使用HarrellC和Akaike信息准则评估模型的性能。相对于1年全因死亡率的5年OS模型，还计算了早期死亡模型的净重新分类改进。共招募了121例晚期颊癌患者。平均年龄为56.1±9.8岁；117例（96.7%）患者为男性。sTIL≤30%,临床淋巴结疾病，病理性淋巴结疾病，分化差,淋巴管浸润,神经周浸润,单因素分析中WPOI5和无辅助放疗是早期死亡的危险因素。在多变量分析中，临床TNM，sTIL,临床淋巴结疾病，分化差,淋巴管浸润,无辅助RT是早期死亡的独立因素。sTIL,病理性淋巴结疾病，分化差,淋巴管浸润,在多因素病理TNM模型中，无辅助RT是早期死亡的独立因素。早期死亡模型对1年全因死亡率的判别能力较好。最后,将sTIL掺入早期死亡模型中,临床TNM模型的净重新分类增加了21%,病理性TNM模型的净重新分类增加了28%.添加sTIL改善了早期死亡模型，这可能有助于医生识别高危患者进行更深入的治疗和随访。
