Analysis of prognostic factors in patients with locally advanced cervical squamous cell carcinoma and development of a nomogram prediction model

Abstract

To develop and validate a predictive model integrating patient demographics and clinical data for estimating 3-, 4-, and 5-year overall survival in patients with locally advanced cervical squamous cell carcinoma (LACSC). Clinical data from 670 LACSC patients at Shanxi Cancer Hospital were collected and then randomly assigned to a training cohort and an internal validation cohort at a 6:4 ratio by stratified sampling. Independent prognostic factors were identified using LASSO regression and multivariate Cox regression analysis, with which a predictive model was constructed. Model performance was assessed using the concordance index (C-index), receiver operating characteristic (ROC) curves, and calibration curves. Clinical utility was evaluated via decision curve analysis (DCA). A robust prognostic model was developed and visualized as a nomogram comprising six variables: NEUT, MONO, CA125, SII, lymph node metastasis status, and treatment modality. Patients were stratified into high- and low-risk groups based on the median risk score in the training cohort. The high-risk group exhibited significantly poorer overall survival (OS) in both cohorts ( P  < 0.05). A clinical predictive model was established to estimate 3-, 4-, and 5-year survival rates for LACSC patients.