RESUMEN
BACKGROUND: Supraglottic squamous cell carcinoma (SGSCC) is characterized by low differentiation, rapid growth, and inconspicuous initial manifestations. Early detection and prompt treatment can significantly improve survival rates. The main focus of treatment is to maintain optimal laryngeal function. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we conducted univariate and multivariate Cox regression analyses to identify independent prognostic factors for T1-T2 SGSCC. We also enrolled 109 patients with T1-T2 SGSCC from the First Affiliated Hospital of Xinjiang Medical University as an external validation set. In addition, we developed a nomogram to predict the prognosis of T1-T2 SGSCC, assessed the predictive accuracy and discriminatory ability of the nomogram using the area under the curve (AUC), C-index, receiver operating characteristic (ROC) curve and calibration curve, and confirmed the clinical validity of the nomogram using decision curve analysis (DCA). RESULTS: Our investigation identified nine prognostic indicators for T1-T2 SGSCC: age (≥ 65 years), marital status, American Joint Committee on Cancer (AJCC) stage (II-IV), grade (III-IV), M stage (M1), radiotherapy, chemotherapy, sex (female), and surgery. These variables were used to create accurate nomograms that predict overall and specific survival rates at 1, 3, and 5 years. The nomograms demonstrated superior prognostic value and accuracy compared to AJCC staging. Laryngectomy with partial laryngectomy is the preferred treatment option for T1-T2 SGSCC cases, providing superior overall survival (OS) and cancer-specific survival (CSS). Radiotherapy also improves OS and CSS. Our results were based on a comprehensive analysis of various indicators, including the C-index, ROC curve, calibration curve, and DCA curve. CONCLUSION: Nomograms provide significant advantages in treatment decision making and diagnosis. Laryngectomy with partial laryngectomy is the most appropriate method for T1-T2 SGSCC cases. However, radiotherapy can also be used. Thus, patients with T1-T2 SGSCC should be evaluated to determine if combination therapy is the optimal treatment approach. Nevertheless, further research is needed to understand the role of chemotherapy. Overall, this study identified nine key predictors of future outcomes, aiding healthcare professionals in assessing risks and making treatment decisions for T1-T2 SGSCC patients.
RESUMEN
Reduction in DNA repair capacity is associated with increased rates of birth defects, cancer, and accelerated aging. According to some earlier studies, genetic polymorphisms in DNA repair genes might influence the repair activities of the enzymes predisposing individuals to cancer risk. Owing to the presence of these genetic variants, inter-individual and ethnic differences in DNA repair capacity have been observed in various populations. Polymorphisms in DNA repair genes and differences in repair capacity between individuals have been widely reported in different cancers. We conducted a case-control study to examine the role of genetic polymorphisms in XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489), Arg194Trp (rs1799782) in the risk of laryngeal cancer in different ethnic groups in Xinjiang. This study included 58 laryngeal cancer patients and 120 healthy controls age- and sex-matched without cancer. The genotypes of XRCC1Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489) and Arg194Trp (rs1799782) were analyzed by PCR-RFLP, and the odds ratio (OR) and 95% confidence interval (CI) were calculated using an unconditional logistic regression model. C/T (hybrid) and T/T (mutant) genotypes of XRCC1 Arg280His (rs25489) revealed no statistical significance in the risk of laryngeal cancer (P>0.05), whereas the genotypes of XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489), Arg194Trp (rs1799782) showed a higher risk than the controls (P<0.01) in Han, Uygur, and Kazak nations. In conclusion, the current study suggests that XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), and Arg194Trp (rs1799782) polymorphisms may be associated with laryngeal cancer risk in the Han, Uygur, and Kazakh populations in Xinjiang. Individuals carrying genotype Arg/Gln+Gln/Gln showed a greater risk than those carrying Arg/Arg for laryngeal cancer in the Han, Uygur and Kazakh ethnic groups, and the odds ratios are 1.47, 1.32, and 0.77.