A novel nomogram with preferable capability in predicting the overall survival of patients after radical esophageal cancer resection based on accessible clinical indicators: A comparison with AJCC staging.
A novel nomogram with preferable capability in predicting the overall survival of patients after radical esophageal cancer resection based on accessible clinical indicators: A comparison with AJCC staging.
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作者：
Li X;Xu J;Zhu L;Yang S;Yu L;Lv W;Hu J
食管癌是一种死亡率很高的恶性肿瘤。诺模图是临床预后评估的重要工具。我们的目的是建立一种新的诺模图来预测食管癌患者根治性食管切除术后的总生存期（OS）。回顾性研究了311例接受根治性食管切除术的EC患者的生存率、人口统计学和临床病理学数据。采用考克斯风险回归分析建立诺模图。校准曲线和Harrell一致性指数（C-指数）用于验证预测准确性，ROC曲线用于评估诺模图的有效性。Kaplan-Meier曲线显示了相关危险分类系统的预后价值。采用Pearson相关性检验确定危险度分级系统与TNM分期的相关性。主要队列和验证队列的中位OS和5年生存率分别为44个月和29.8%以及52个月和27.1%。我们在列线图中使用了六个独立的预后因素-年龄、性别、AGR、PRL、N分期和PNI。主要队列和验证队列中列线图的C指数分别为0.75和0.70。校正曲线显示实际OS与预测OS高度一致，ROC曲线显示诺模图在两个队列中的疗效均优于TNM分期。根据列线图总评分将患者分为3个风险组，两个队列中各组的中位OS差异有统计学意义。此外，风险分类系统与T和N分期系统密切相关，并表现出更好的OS预测能力。我们建立了一个新的和实用的诺模图与从属风险分类系统，预测根治性食管切除术后患者的OS。与AJCC分期相比，该诺模图在个体预后评估方面具有更好的临床应用价值。我们建立并验证了一种新的诺模图来预测食管癌根治术患者的OS，特别是与AJCC分期相比，诺模图显示了相当大的预后能力。此外，还生成了用于临床评价的相关风险分类系统。
Esophageal cancer (EC) is a malignant tumor with high mortality. Nomogram is an important tool used in clinical prognostic assessment. We aimed to establish a novel nomogram to predict the overall survival (OS) of EC patients after radical esophagectomy. Data pertaining to the survival, demography, and clinicopathology of 311 EC patients who underwent radical esophagectomy were retrospectively investigated. The nomogram was established based on Cox hazard regression analysis. The calibration curves and Harrell's concordance index (C‐index) were used to verify the predictive accuracy and ROC curves were used to assess the efficacy of the nomogram. Kaplan–Meier curves showed the prognostic value of the related risk classification system. Pearson correlation test was performed to determine the correlation between the risk classification system and TNM staging. The median OS and 5‐year survival rates in the primary and validation cohorts were 44 months and 29.8%, and 52 months and 27.1%, respectively. We used six independent prognostic factors—age, Sex, AGR, PRL, N stage, and PNI—in the nomogram. The C‐index of nomogram was 0.75 and 0.70 in the primary and validation cohorts, respectively. Calibration curves indicated high consistency between actual and predicted OS. ROC curves showed that nomogram has a better efficacy compared with TNM staging in both cohorts. Patients were divided into three risk groups according to the total nomogram score, the median OS in each group was significantly different in both cohorts. Furthermore, the risk classification system was strongly correlated with the T and N staging system and exhibited a better OS prediction capability. We established a novel and practical nomogram with a subordinate risk classification system to predict the OS of patients after radical esophagectomy. Compared with AJCC staging, this nomogram had preferable clinical capability in terms of individual prognosis assessment. We built and validated a novel nomogram to predict OS in radical esophageal cancer resection patients, the nomogram showed considerable prognostic capability especially compared with AJCC staging. Furthermore, a related risk classification system was generated for clinical evaluation.
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影响因子：
3
作者：
Oki, Satoshi;Toiyama, Yuji;Kusunoki, Masato
通讯作者：
Kusunoki, Masato
影响因子：
9
作者：
Semenkovich, Tara R.;Hudson, Jessica L.;Kozower, Benjamin D.
通讯作者：
Kozower, Benjamin D.
影响因子：
1.7
作者：
Koziol, James A.;Jia, Zhenyu
通讯作者：
Jia, Zhenyu
DOI：
10.1016/s1470-2045(14)71116-7
发表时间：
2015-04
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Balachandran VP;Gonen M;Smith JJ;DeMatteo RP
通讯作者：
DeMatteo RP
影响因子：
7.4
作者：
Chen S;Lai Y;He Z;Li J;He X;Shen R;Ding Q;Chen H;Peng S;Liu W
通讯作者：
Liu W