Literature DB >> 26819278

Prognostic nomogram for previously untreated patients with esophageal squamous cell carcinoma after esophagectomy followed by adjuvant chemotherapy.

Jingjing Duan1, Ting Deng1, Guoguang Ying1, Dingzhi Huang1, Haiyang Zhang1, Likun Zhou1, Ming Bai1, Hongli Li1, Huimin Yang1, Yanjun Qu1, Xia Wang1, Yi Ba2.   

Abstract

OBJECTIVE: The aim of the study was to establish an effective prognostic nomogram for esophageal squamous cell carcinoma after radical esophagectomy followed by adjuvant chemotherapy in those previously untreated patients.
METHODS: The clinicopathological data from 328 patients who underwent radical esophagectomy followed by adjuvant chemotherapy or not at the Tianjin Medical University Cancer Institute and Hospital between 2006 and 2010 were retrospectively studied. Nomograms which predicted survival of esophageal squamous cell carcinoma were established based on the Cox proportional hazards regression model. To determine its predictive accuracy and discriminatory capacity, the concordance index and calibration curve were calculated after bootstrapping in the internal validation. An external validation of 76 patients in 2011 was prospectively studied at the same institution. To verify the performance of the nomogram, the comparison between the nomogram and Tumor-Node-Metastasis staging system was conducted.
RESULTS: The 5-year overall survival was 43.1% in the primary cohort. Based on multivariate analyses, five independent prognostic variables including gender, tumor length, T stage, N stage and chemotherapy cycles were selected to build the nomograms to predict disease-free survival and overall survival. The concordance index of the nomogram to predict overall survival was 0.71 (95% confidence interval, 0.63-0.79), which was superior to the predictive power of Tumor-Node-Metastasis staging system (0.64) in the primary cohort. Meanwhile, the calibration curve showed good accuracy between predictive and actual overall survival. In the validation cohort, the concordance index (0.77) and calibration plot displayed favorable performances. The other nomogram to predict disease-free survival also performed well.
CONCLUSIONS: The prognostic nomogram provided individualized risk estimate of survival in patients after esophagectomy followed by adjuvant chemotherapy.
© The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Entities:  

Keywords:  adjuvant chemotherapy; esophageal squamous cell carcinoma; esophagectomy; nomogram; prognosis

Mesh:

Year:  2016        PMID: 26819278      PMCID: PMC4886130          DOI: 10.1093/jjco/hyv206

Source DB:  PubMed          Journal:  Jpn J Clin Oncol        ISSN: 0368-2811            Impact factor:   3.019


  46 in total

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