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Prognostic factors for patients with pathologic T1-T2N+ esophageal squamous cell carcinoma: A retrospective study with external validation.
Jiang, Kai-Yuan; Zhang, Sheng-Xuan; Hu, Wen-Long; Deng, Zhi-Qiang; Zhang, Jun-Jie; Guo, Xiao-Guang; Jian, Shun-Hai; Zhou, Hai-Ning; Tian, Dong.
Afiliación
  • Jiang KY; Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China; Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Zhang SX; College of Clinical Medicine, North Sichuan Medical College, Nanchong, China.
  • Hu WL; College of Clinical Medicine, North Sichuan Medical College, Nanchong, China.
  • Deng ZQ; College of Medical Imaging, North Sichuan Medical College, Nanchong, China.
  • Zhang JJ; College of Medical Imaging, North Sichuan Medical College, Nanchong, China.
  • Guo XG; School of Biomedical Engineering, Hainan University, Haikou, China.
  • Jian SH; Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
  • Zhou HN; Department of Thoracic Surgery, Suining Central Hospital, Suining, China. Electronic address: zhouhaining@aliyun.com.
  • Tian D; Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China. Electronic address: 22tiandong@wchscu.cn.
Surgery ; 176(3): 730-738, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38902127
ABSTRACT

BACKGROUND:

Lymph node metastasis is significantly associated with a worse prognosis in patients with localized early-stage esophageal squamous cell carcinoma. This study aimed to explore the prognostic factors and develop a nomogram for predicting survival in patients with pathologic T1-2N+ esophageal squamous cell carcinoma.

METHODS:

Between 2014 and 2022, patients with pT1-2N+ esophageal squamous cell carcinoma who underwent esophagectomy with lymphadenectomy at 2 institutes were reviewed and assigned to training and external validation cohorts. Independent prognostic factors were identified via univariate and multivariate Cox regression analyses. The nomogram model was developed and evaluated by the area under the receiver operating characteristic curve and calibration curve.

RESULTS:

In total, 268 patients with a median age of 65 years (range, 40-82) were included and assigned to training (n = 190) and external validation (n = 78) cohorts. The Cox proportional hazards model demonstrated that body mass index (P = .031), surgical approach (P < .001), T stage (P = .015), and Clavien-Dindo classification (P < .001) were independent prognostic factors in the training cohort. The nomogram showed good discrimination, with an area under the receiver operating characteristic curve for 1-year, 3-year, and 5-year of 0.810, 0.789, and 0.809 in the training cohort and 0.782, 0.679, and 0.698 in the validation cohort. The calibration curve showed that the predicted survival probability was in good agreement with the actual survival probability.

CONCLUSION:

Lower body mass index, left surgical approach, T2 stage, and Clavien-Dindo classification grade III to V were related to worse prognosis in patients with pT1-T2N+ esophageal squamous cell carcinoma. The developed nomogram may predict individual survival accurately.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Esofagectomía / Nomogramas / Carcinoma de Células Escamosas de Esófago / Estadificación de Neoplasias Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Surgery Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Esofagectomía / Nomogramas / Carcinoma de Células Escamosas de Esófago / Estadificación de Neoplasias Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Surgery Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos