A nomogram associated with high probability of malignant nodes in the surgical specimen after trimodality therapy of patients with oesophageal cancer.
A nomogram associated with high probability of malignant nodes in the surgical specimen after trimodality therapy of patients with oesophageal cancer.
复制标题
DOI：
10.1016/j.ejca.2012.06.020
复制
发表时间：
2012-12
影响因子：
8.4
通讯作者：
Ajani, Jaffer A.
中科院分区：
文献类型：
--
作者：
Hayashi, Yuki;Xiao, Lianchun;Suzuki, Akihiro;Blum, Mariela A.;Sabloff, Bradley;Taketa, Takashi;Maru, Dipen M.;Welsh, James;Lin, Steven H.;Weston, Brian;Lee, Jeffrey H.;Bhutani, Manoop S.;Hofstetter, Wayne L.;Swisher, Stephen G.;Ajani, Jaffer A.
食管癌（EC）患者术前放化疗（三联疗法）后手术标本中存在恶性淋巴结（+ypNodes）预示着总生存期（OS）和无病生存期（DFS）的预后不良。没有一个临床参数与+ypNodes相关。我们假设临床参数的组合可能提供一个模型，该模型与三模态EC患者中+ypNodes的高可能性相关。我们报告了293例连续EC患者接受三联疗法。进行多变量logistic回归分析，包括治疗前和放疗后参数，以确定用于构建三模态EC患者+ypNode列线图的自变量。在293例患者中，91例（31.1%）有+ypNode。在多变量分析中，与+ypNodes相关的显著因素为：基线T分期（比值比[OR]，7.145; 95%置信区间[CI]，1.381-36.969; p=0.019），基线N分期（OR，2.246; 95% CI，1.024-4.926; p=0.044），肿瘤长度（OR，1.178; 95% CI，1.024-1.357; p=0.022），诱导化疗（OR，0.471; 95% CI，0.242-0.915; p=0.026），放化疗后PET显示的淋巴结转移（OR，2.923; 95% CI，1.007-8.485; p=0.049）和放化疗后CT显示的淋巴结转移（OR，3.465; 95% CI，1.549-7.753; p=0.002）。使用bootstrap方法进行内部验证后的列线图产生了0.756的高一致性指数（95% CI，xx-xx）。我们的研究结果表明，构建的诺模图高度相关的存在+ypNodes和验证后，它可以证明是有用的，在个体化治疗的三模态患者与EC。
The presence of malignant lymph nodes in the surgical specimen (+ypNodes) after preoperative chemoradiation (trimodality) in patients with esophageal cancer (EC) portends a poor prognosis for overall survival (OS) and disease-free survival (DFS). There is not one clinical parameter that is correlated with +ypNodes. We hypothesized that a combination of clinical parameters might provide a model that would associate with the high likelihood of +ypNodes in trimodality EC patients. We report on 293 consecutive EC patients who received trimodality therapy. A multivariate logistic regression analysis that included pretreatment and post-chmoradiation parameters was performed to identify independent variables that were used to construct a nomogram for +ypNodes in trimodality EC patients. Of 293 patients, 91 (31.1%) had +ypNodes. In multivariable analysis, the significant factors associated with +ypNodes were: baseline T stage (odds ratio [OR], 7.145; 95% confidence interval [CI], 1.381-36.969; p=0.019), baseline N stage (OR, 2.246; 95% CI, 1.024-4.926; p=0.044), tumor length (OR, 1.178; 95% CI, 1.024-1.357; p=0.022), induction chemotherapy (OR, 0.471; 95% CI, 0.242-0.915; p=0.026), lymph metastasis by post-chemoradiation PET (OR, 2.923; 95% CI, 1.007-8.485; p=0.049) and enlarged lymph node metastasis by post-chemoradiation CT (OR, 3.465; 95% CI, 1.549-7.753; p=0.002). The nomogram after internal validation using the bootstrap method yielded a high concordance index of 0.756 (95% CI, xx-xx). Our results suggest that the constructed nomogram highly correlates with the presence of +ypNodes and upon validation; it could prove useful in individualizing therapy for trimodality patients with EC.
登录
查看更多内容
影响因子：
3.7
作者：
Bollschweiler, Elfriede;Besch, Sarah;Hoelscher, Arnulf H.
通讯作者：
Hoelscher, Arnulf H.
影响因子：
3.3
作者：
Bollschweiler, Elfriede;Hoelscher, Arnulf H.;Metzger, Ralf
通讯作者：
Metzger, Ralf
影响因子：
3.7
作者：
Gaca, JG;Petersen, RP;Tyler, DS
通讯作者：
Tyler, DS
影响因子：
6.2
作者：
Gu, Y;Swisher, SG;Wu, TT
通讯作者：
Wu, TT
影响因子：
6.2
作者：
Suzuki, Akihiro;Xiao, Lianchun;Ajani, Jaffer A.
通讯作者：
Ajani, Jaffer A.