{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:31:57Z","timestamp":1785900717203,"version":"3.56.0"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P50 CA097248"],"award-info":[{"award-number":["P50 CA097248"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,2,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Accurate prognostication is essential to the optimal management of laryngeal cancer. Predictive models have been developed to calculate the risk of oncologic outcomes, but extensive external validation of accuracy and reliability is necessary before implementing them into clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHOD<\/jats:title><jats:p>Four published prognostic calculators that predict 5\u2010year overall survival for patients with laryngeal cancer were evaluated using patient information from a prospective epidemiology study cohort (n\u2009=\u2009246; median follow\u2010up, 60 months) with previously untreated, stage I through IVb laryngeal squamous cell carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Different calculators yielded substantially different predictions for individual patients. The observed 5\u2010year overall survival was significantly higher than the averaged predicted 5\u2010year overall survival of the 4 calculators (71.9%; 95% confidence interval [CI], 65%\u201078%] vs 47.7%). Statistical analyses demonstrated the calculators' limited capacity to discriminate outcomes for risk\u2010stratified patients. The area under the receiver operating characteristic curve ranged from 0.68 to 0.72. C\u2010index values were similar for each of the 4 models (range, 0.66\u20100.68). There was a lower than expected hazard of death for patients who received induction (bioselective) chemotherapy (hazard ratio, 0.46; 95% CI, 0.24\u20100.88; <jats:italic>P<\/jats:italic>\u2009=\u2009.024) or primary surgical intervention (hazard ratio, 0.43; 95 % CI, 0.21\u20100.90; <jats:italic>P<\/jats:italic>\u2009=\u2009.024) compared with those who received concurrent chemoradiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Suboptimal reliability and accuracy limit the integration of existing individualized prediction tools into routine clinical decision making. The calculators predicted significantly worse than observed survival among patients who received induction chemotherapy and primary surgery, suggesting a need for updated consideration of modern treatment modalities. Further development of individualized prognostic calculators may improve risk prediction, treatment planning, and counseling for patients with laryngeal cancer. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:706\u201016.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31087","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T09:28:42Z","timestamp":1510046922000},"page":"706-716","source":"Crossref","is-referenced-by-count":14,"title":["Individualized outcome prognostication for patients with laryngeal cancer"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2601-6193","authenticated-orcid":false,"given":"Connor W.","family":"Hoban","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren J.","family":"Beesley","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan School of Public Health Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L.","family":"Bellile","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan School of Public Health Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan School of Public Health Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7646-6075","authenticated-orcid":false,"given":"Matthew E.","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory T.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M. 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