The potential use of the prediction model using the 17 patients in this study in clinical practice.
A, Actual response. In our patient population, all 17 patients underwent induction chemotherapy. Twelve patients responded (+) and received additional chemotherapy and radiation; 5 patients underwent surgery and radiation.
B, Using ≥90% pretest probability as a threshold. In this hypothetical application of the prediction rule, 10 patients would be directed immediately to organ preservation, whereas 7 patients would undergo induction chemotherapy. Of those 7 patients, 2 patients would respond and proceed to organ preservation therapy, and the remaining 5 patients would proceed to surgery and radiation.
C, Using ≥10% pretest probability as a threshold. In this hypothetical application, 2 patients would receive immediate surgery and radiation, whereas 15 would undergo induction chemotherapy. Using this low threshold, 3 patients would not respond to induction chemotherapy with potential delay in more invasive, but appropriate, surgery and radiation therapy.