Jun Wang1, Le Shi1, Jing Chen1, Beidi Wang1, Jia Qi1, Guofeng Chen1, Muxing Kang1, Hang Zhang1, Xiaoli Jin1, Yi Huang1, Zhiqing Zhao2, Jianfeng Chen2, Bin Song2, Jian Chen3. 1. Department of Gastroenterology Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310000, China. 2. Department of Gastroenterology Surgery, Shaoxing Shangyu People's Hospital and Shangyu Hospital of the Second Affiliated Hospital, Zhejiang University School of Medicine, Shaoxing, Zhejiang, 312300, China. 3. Department of Gastroenterology Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310000, China. zrchenjian@zju.edu.cn.
Abstract
BACKGROUND: The incidence rate of adenocarcinoma of the oesophagogastric junction (AEG) has significantly increased over the past decades, with a steady increase in morbidity. The aim of this study was to explore a variety of clinical factors to judge the survival outcomes of AEG patients. METHODS: We first obtained the clinical data of AEG patients from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and least absolute shrinkage and selection operator (LASSO) regression models were used to build a risk score system. Patient survival was analysed using the Kaplan-Meier method and the log-rank test. The specificity and sensitivity of the risk score were determined by receiver operating characteristic (ROC) curves. Finally, the internal validation set from the SEER database and external validation sets from our center were used to validate the prognostic power of this model. RESULTS: We identified a risk score system consisting of six clinical features that can be a good predictor of AEG patient survival. Patients with high risk scores had a significantly worse prognosis than those with low risk scores (log-rank test, P-value < 0.0001). Furthermore, the areas under ROC for 3-year and 5-year survival were 0.74 and 0.75, respectively. We also found that the benefits of chemotherapy and radiotherapy were limited to stage III/IV AEG patients in the high-risk group. Using the validation sets, our novel risk score system was proven to have strong prognostic value for AEG patients. CONCLUSIONS: Our results may provide new insights into the prognostic evaluation of AEG.
BACKGROUND: The incidence rate of adenocarcinoma of the oesophagogastric junction (AEG) has significantly increased over the past decades, with a steady increase in morbidity. The aim of this study was to explore a variety of clinical factors to judge the survival outcomes of AEGpatients. METHODS: We first obtained the clinical data of AEGpatients from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and least absolute shrinkage and selection operator (LASSO) regression models were used to build a risk score system. Patient survival was analysed using the Kaplan-Meier method and the log-rank test. The specificity and sensitivity of the risk score were determined by receiver operating characteristic (ROC) curves. Finally, the internal validation set from the SEER database and external validation sets from our center were used to validate the prognostic power of this model. RESULTS: We identified a risk score system consisting of six clinical features that can be a good predictor of AEGpatient survival. Patients with high risk scores had a significantly worse prognosis than those with low risk scores (log-rank test, P-value < 0.0001). Furthermore, the areas under ROC for 3-year and 5-year survival were 0.74 and 0.75, respectively. We also found that the benefits of chemotherapy and radiotherapy were limited to stage III/IV AEGpatients in the high-risk group. Using the validation sets, our novel risk score system was proven to have strong prognostic value for AEGpatients. CONCLUSIONS: Our results may provide new insights into the prognostic evaluation of AEG.
Authors: Lei Chen; Xiaopeng Guo; Shi Chen; Yanqiao Ren; Tao Sun; Fan Yang; Chuansheng Zheng Journal: Am J Transl Res Date: 2021-01-15 Impact factor: 4.060
Authors: Thomas W Rice; Donna M Gress; Deepa T Patil; Wayne L Hofstetter; David P Kelsen; Eugene H Blackstone Journal: CA Cancer J Clin Date: 2017-05-26 Impact factor: 508.702