Prognostic Nomogram for Predicting Long-Term Overall Survival of Esophageal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy Plus Surgery: A Population-Based Study

Frontiers in Surgery

article

Zhinuan Hong¹  Zhimin Shen¹  Lei Gao¹  Mingqiang Kang¹  Mingduan Chen¹ 

[1] Department of Thoracic Surgery, Fujian Medical University Union Hospital;Key Laboratory of Cardio-Thoracic Surgery ,(Fujian Medical University), Fujian Province University;Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University;Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University

关键词: esophageal cancer;    neoadjuvant chemoradiotherapy;    long-term survival;    population-based study;    SEER;    follow-up plan;   

DOI  :  10.3389/fsurg.2022.927457

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Neoadjuvant chemoradiotherapy (nCRT) plays an important role in patients with locally advanced esophageal cancer (EC). We aim to determine the prognostic risk factors and establish a reliable nomogram to predict overall survival (OS) based on SEER population. Methods Patients with EC coded by 04–15 in the SEER database were included. The data were divided into training group and verification group (7:3). The Cox proportional-risk model was evaluated by using the working characteristic curve (receiver operating characteristic curve, ROC) and the area under the curve (AUC), and a nomogram was constructed. The calibration curve was used to measure the consistency between the predicted and the actual results. Decision curve analysis (DCA) was used to evaluate its clinical value. The best cut-off value of nomogram score in OS was determined by using X-tile software, and the patients were divided into low-risk, medium-risk, and high-risk groups. Results A total of 2,209 EC patients who underwent nCRT were included in further analysis, including 1,549 in the training cohort and 660 in the validation group. By Cox analysis, sex, marital status, T stage, N stage, M stage, and pathological grade were identified as risk factors. A nomogram survival prediction model was established to predict the 36-, 60-, and 84-month survival. The ROC curve and AUC showed that the model had good discrimination ability. The correction curve was in good agreement with the prediction results. DCA further proved the effective clinical value of the nomogram model. The results of X-tile analysis showed that the long-term prognosis of patients in the low-risk subgroup was better in the training cohort and the validation cohort ( p  < 0.001). Conclusion This study established an easy-to-use nomogram risk prediction model consisting of independent prognostic factors in EC patients receiving nCRT, helping to stratify risk, identify high-risk patients, and provide personalized treatment options.

【 授权许可】

CC BY