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| Construction of a Prediction Model for Recurrence after Transnasal Endoscopic Surgery in Patients with Recurrent Nasopharyngeal Carcinoma |
| WANG Xiaoyan, DAI Chenxi, NIU Qinghua, et al |
| Department of Otorhinolaryngology, Lankao First Hospital, Lankao Henan 475300 |
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Abstract 【Objective】To construct a prediction model for recurrence after transnasal endoscopic surgery in patients with recurrent nasopharyngeal carcinoma (NPC). 【Methods】The clinical data of 133 patients with recurrent NPC who underwent transnasal endoscopic surgery in our hospital from April 2020 to April 2023 were retrospectively analyzed. All patients were followed up for 2 years and divided into recurrence group and non-recurrence group according to postoperative recurrence status. Univariate and multivariate analyses were used to identify influencing factors of postoperative recurrence, and a Nomogram model was constructed to predict recurrence risk. The predictive efficacy was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). 【Results】The 2-year postoperative recurrence rate was 32.33% (43/133). Univariate analysis showed that the recurrence group had higher proportions of clinical stage Ⅲ-Ⅳ, systemic immune-inflammation index (SII) ≥445.3, poor differentiation, lymph node metastasis, and positive EB virus DNA load, and lower proportion of albumin level ≥35 g/L (P<0.05). Binary Logistic regression showed that high clinical stage, high SII, and positive EB virus DNA load were independent risk factors for postoperative recurrence (P<0.05), while high albumin level was an independent protective factor (P<0.05). The Nomogram model constructed based on these factors had a C-index of 0.852 by Bootstrap internal validation, with the calibration curve approaching the ideal curve (P>0.05). ROC curve showed the model had a sensitivity of 88.40%, specificity of 87.80%, and AUC of 0.883 for predicting recurrence. 【Conclusion】High clinical stage, high SII, and positive EB virus DNA load are independent risk factors for postoperative recurrence, while high albumin level is an independent protective factor. The Nomogram model based on these factors can effectively assess the recurrence risk of NPC patients after surgery.
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Received: 13 May 2025
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2025, Vol. 42 
