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In Frontiers in oncology ; h5-index 0.0

Surgical decision-making on advanced laryngeal carcinoma is heavily depended on the identification of preoperative T category (T3 vs. T4), which is challenging for surgeons. A T category prediction radiomics (TCPR) model would be helpful for subsequent surgery. A total of 211 patients with locally advanced laryngeal cancer who had undergone total laryngectomy were randomly classified into the training cohort (n = 150) and the validation cohort (n = 61). We extracted 1,390 radiomic features from the contrast-enhanced computed tomography images. Interclass correlation coefficient and the least absolute shrinkage and selection operator (LASSO) analyses were performed to select features associated with pathology-confirmed T category. Eight radiomic features were found associated with preoperative T category. The radiomic signature was constructed by Support Vector Machine algorithm with the radiomic features. We developed a nomogram incorporating radiomic signature and T category reported by experienced radiologists. The performance of the model was evaluated by the area under the curve (AUC). The T category reported by radiologists achieved an AUC of 0.775 (95% CI: 0.667-0.883); while the radiomic signature yielded a significantly higher AUC of 0.862 (95% CI: 0.772-0.952). The predictive performance of the nomogram incorporating radiomic signature and T category reported by radiologists further improved, with an AUC of 0.892 (95% CI: 0.811-0.974). Consequently, for locally advanced laryngeal cancer, the TCPR model incorporating radiomic signature and T category reported by experienced radiologists have great potential to be applied for individual accurate preoperative T category. The TCPR model may benefit decision-making regarding total laryngectomy or larynx-preserving treatment.

Wang Fei, Zhang Bin, Wu Xiangjun, Liu Lizhi, Fang Jin, Chen Qiuying, Li Minmin, Chen Zhuozhi, Li Yueyue, Dong Di, Tian Jie, Zhang Shuixing


T category, advanced laryngeal cancer, computed tomography, nomogram, radiomics