4. Discussion
tumor, TSCC, squamous cell carcinoma of the tongue, tumors
TUMOR, METASTASIS, RECURRENCE, LYMPH NODE METASTASES, TUMOR METASTASIS, BEST, LYMPHATIC VESSELS, TUMOR METASTASIS, TUMORS
KTSCC is a subhistological type of squamous cell carcinoma of the tongue. To the best of our knowledge, TSCC is the most researched at present, and few people study KTSCC independently and systematically [The AJCC system is currently available to assess the prognoses of most tumors but this method is based only on tumor histology, and does not take into account sociological and individual factors such as the economic status, race, and treatment conditions of patients. Our new nomogram model incorporated various comprehensive factors, including economic status, race, marital status, treatments, and other factors that independently affect the prognosis of KTSCC, and it can better predict the OS rate of patients with KTSCC. Comparing it with the AJCC staging system revealed that our new model can provide more accurate information, and for clinicians to use when performing diagnoses and formulating treatment plans for patients.Age has been an independent factor affecting TSCC prognosis. Best et al. [This study also found that among the factors influencing KTSCC prognosis, tumor size, AJCC stage, SEER tumor stage, radiotherapy status, and postoperative lymph node dissection also affected the overall survival probability. Our findings indicated that larger tumors caused worse KTSCC prognoses. Similarly, in SEER staging, more-widespread tumor metastasis is associated with a worse prognosis, with distant metastasis having the worst prognosis. These results were closely related to the special location of the tongue that is rich in blood vessels with its adjacent lymphatic vessels. With the development of tumors, localized invasion, and lymph node metastases often occur at an early stage, and distant metastasis eventually occurs. Tumor metastasis will adversely affect the prognosis.It is worth noting that our study found that radiotherapy status and postoperative lymph node dissection were protective factors for KTSCC prognosis. The current main treatment method for KTSCC is surgery. Postoperative selective neck lymph node dissection can increase the OS of patients and control recurrence. Consistent with the study by Kurita et al. [We have established a new predictive model (C-index and AUC were used to test the discrimination of the new model, which would be found to have better discrimination ability. The results for the quantitative indicators NRI and IDI demonstrated that the accuracy of our model in predicting survival probabilities was significantly better than that of the AJCC staging system. The calibration curve plot of this model was found to be highly consistent with the standard curve, and the DCA plot indicated that the net benefit of our model in predicting the prognosis of patients with KTSCC was superior to that of the AJCC staging system [This study had certain shortcomings. Selection bias: this study is a retrospective design, which can easily lead to selection and information biases. More sociological and biological factors need to be included in the research: clinicopathological factors, certain biological indicators, and patient behavior habits that affect prognosis are not included in the SEER database. Further confirmation is needed in prospective studies: prospective studies of the developed nomogram are still needed to further test and confirm its predictive power, which will be the focus of our future research.