J Shapiro1, D van Klaveren2, S M Lagarde1,3, E L A Toxopeus1, A van der Gaast4, M C C M Hulshof5, B P L Wijnhoven1, M I van Berge Henegouwen3, E W Steyerberg2, J J B van Lanschot1. 1. Departments of Surgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands. 2. Departments of Public Health, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands. 3. Departments of Surgery, Academic Medical Centre, Amsterdam, The Netherlands. 4. Departments of Medical Oncology, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands. 5. Departments of Radiotherapy, Academic Medical Centre, Amsterdam, The Netherlands.
Abstract
BACKGROUND: The value of conventional prognostic factors is unclear in the era of multimodal treatment for oesophageal cancer. This study aimed to quantify the impact of neoadjuvant chemoradiotherapy (nCRT) and surgery on well established prognostic factors, and to develop and validate a prognostic model. METHODS: Patients treated with nCRT plus surgery were included. Multivariable Cox modelling was used to identify prognostic factors for overall survival. A prediction model for individual survival was developed using stepwise backward selection. The model was internally validated leading to a nomogram for use in clinical practice. RESULTS: Some 626 patients who underwent nCRT plus surgery were included. In the multivariable model, only pretreatment cN category and ypN category were independent prognostic factors. The final prognostic model included cN, ypT and ypN categories, and had moderate discrimination (c-index at internal validation 0·63). CONCLUSION: In patients with oesophageal or oesophagogastric cancer treated with nCRT plus surgery, overall survival can best be estimated using a prediction model based on cN, ypT and ypN categories. Predicted survival according to this model showed only moderate correlation with observed survival, emphasizing the need for new prognostic factors to improve survival prediction.
BACKGROUND: The value of conventional prognostic factors is unclear in the era of multimodal treatment for oesophageal cancer. This study aimed to quantify the impact of neoadjuvant chemoradiotherapy (nCRT) and surgery on well established prognostic factors, and to develop and validate a prognostic model. METHODS:Patients treated with nCRT plus surgery were included. Multivariable Cox modelling was used to identify prognostic factors for overall survival. A prediction model for individual survival was developed using stepwise backward selection. The model was internally validated leading to a nomogram for use in clinical practice. RESULTS: Some 626 patients who underwent nCRT plus surgery were included. In the multivariable model, only pretreatment cN category and ypN category were independent prognostic factors. The final prognostic model included cN, ypT and ypN categories, and had moderate discrimination (c-index at internal validation 0·63). CONCLUSION: In patients with oesophageal or oesophagogastric cancer treated with nCRT plus surgery, overall survival can best be estimated using a prediction model based on cN, ypT and ypN categories. Predicted survival according to this model showed only moderate correlation with observed survival, emphasizing the need for new prognostic factors to improve survival prediction.
Authors: S R Markar; B J Noordman; H Mackenzie; J M Findlay; P R Boshier; M Ni; E W Steyerberg; A van der Gaast; M C C M Hulshof; N Maynard; M I van Berge Henegouwen; B P L Wijnhoven; J V Reynolds; J J B Van Lanschot; G B Hanna Journal: Ann Oncol Date: 2017-03-01 Impact factor: 32.976
Authors: H G van den Boorn; E G Engelhardt; J van Kleef; M A G Sprangers; M G H van Oijen; A Abu-Hanna; A H Zwinderman; V M H Coupé; H W M van Laarhoven Journal: PLoS One Date: 2018-02-08 Impact factor: 3.240
Authors: E R C Hagens; M L Feenstra; W J Eshuis; M C C M Hulshof; H W M van Laarhoven; M I van Berge Henegouwen; S S Gisbertz Journal: Br J Surg Date: 2020-02-03 Impact factor: 6.939
Authors: Lucas Goense; Jelle P Ruurda; Brett W Carter; Penny Fang; Linus Ho; Gert J Meijer; Richard van Hillegersberg; Wayne L Hofstetter; Steven H Lin Journal: Eur J Nucl Med Mol Imaging Date: 2018-04-16 Impact factor: 9.236
Authors: Sarah Schumacher; Christoph Bartenhagen; Martin Hoffmann; Daniel Will; Johannes C Fischer; Stephan E Baldus; Christian Vay; Georg Fluegen; Levent Dizdar; Daniel Vallböhmer; Christoph A Klein; Wolfram T Knoefel; Nikolas H Stoecklein; Birte Möhlendick Journal: Br J Cancer Date: 2017-07-20 Impact factor: 7.640