Nomograms predicting overall survival and cancer-specific survival in patients with squamous cell carcinoma based on the Surveillance, Epidemiology, and End Results (SEER) database
- 1Department of Plastic Surgery, Nanchang University Second Affiliated Hospital, Nanchang, China
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.
Related
- Development and temporal validation of nomograms and machine learning models for predicting overall and cancer-specific survival in primary distal cholangiocarcinoma: a SEER-based study
- Association between primary-site surgery and overall survival in non-metastatic and metastatic colorectal cancer: a population-based study using the Surveillance, Epidemiology, and End Results database
- Prognostic factors and conditional survival analysis in primary thyroid lymphoma: a retrospective cohort study using the Surveillance, Epidemiology, and End Results database.
- Bedside Bioimpedance and Simple Functional Tests Identify Muscle Function Impairment Predicting Overall Survival in Chemotherapy-treated Metastatic Urothelial Carcinoma: A Retrospective Pilot Study
- Composite Inflammatory Score for Predicting Progression-Free Survival in Metastatic Clear Cell Renal Cell Carcinoma Treated With First-Line Toripalimab Plus Axitinib.
BibTeX
@article{peng2026nomograms,
title = {{Nomograms predicting overall survival and cancer-specific survival in patients with squamous cell carcinoma based on the Surveillance, Epidemiology, and End Results (SEER) database}},
author = {Ying Peng and Zhixiong Chen},
journal = {Translational Cancer Research},
year = {2026},
month = sep,
doi = {10.21037/tcr-2026-1846},
url = {https://doi.org/10.21037/tcr-2026-1846},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Nomograms predicting overall survival and cancer-specific survival in patients with squamous cell carcinoma based on the Surveillance, Epidemiology, and End Results (SEER) database
AU - Ying Peng
AU - Zhixiong Chen
PY - 2026
DA - 2026/09/28
JO - Translational Cancer Research
DO - 10.21037/tcr-2026-1846
UR - https://doi.org/10.21037/tcr-2026-1846
AB - 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.
SN - 2218-676X
SN - 2219-6803
ER -