A prognostic nomogram for overall survival after neoadjuvant radiotherapy or chemoradiotherapy in thoracic esophageal squamous cell carcinoma: a retrospective analysis

被引:13
作者
Deng, Wei [1 ,2 ]
Wang, Qifeng [3 ]
Xiao, Zefen [1 ,2 ]
Tan, Lijun [4 ]
Yang, Zhao [2 ,5 ]
Zhou, Zongmei [1 ,2 ]
Zhang, Hongxing [1 ,2 ]
Chen, Dongfu [1 ,2 ]
Feng, Qinfu [1 ,2 ]
Liang, Jun [1 ,2 ]
Li, Yexiong [1 ,2 ]
He, Jie [2 ,6 ]
Gao, Shugeng [2 ,6 ]
Sun, Kelin [2 ,6 ]
Cheng, Guiyu [2 ,6 ]
Liu, Xiangyang [2 ,6 ]
Fang, Dekang [2 ,6 ]
Xue, Qi [2 ,6 ]
Mao, Yousheng [2 ,6 ]
Wang, Dali [2 ,6 ]
Li, Jian [2 ,6 ]
机构
[1] Chinese Acad Med Sci, Canc Hosp, Natl Canc Center, Dept Radiat Oncol, Beijing, Peoples R China
[2] Peking Union Med Coll, Beijing, Peoples R China
[3] Sichuan Canc Hosp, Dept Radiat Oncol, Chengdu, Peoples R China
[4] Harbin Med Univ, Hosp 1, Dept Oncol, Harbin, Peoples R China
[5] Chinese Acad Med Sci, Canc Hosp, Natl Canc Ctr, Dept Canc Epidemiol, Beijing, Peoples R China
[6] Chinese Acad Med Sci, Canc Hosp, Natl Canc Center, Dept Thorac Surg, Beijing, Peoples R China
基金
中国国家自然科学基金;
关键词
esophageal carcinoma; nomogram; neoadjuvant therapy; overall survival; recursive partitioning analysis; PATHOLOGICAL COMPLETE RESPONSE; PREOPERATIVE CHEMORADIATION; GASTROESOPHAGEAL JUNCTION; STAGING SYSTEM; CANCER; THERAPY; CHEMOTHERAPY; RESECTION; ADENOCARCINOMA; METAANALYSIS;
D O I
10.18632/oncotarget.17062
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Currently, the AJCC staging system or pathological complete response (pCR) are considered not sufficiently accurate to evaluate the survival of patients with esophageal squamous cell carcinoma after neoadjuvant radiotherapy or chemoradiotherapy. This study aimed to establish a nomogram and a recursive partitioning analysis (RPA) model to estimate prognosis and to provide advice for subsequent treatments. Methods: We analyzed retrospectively 407 patients that were diagnosed with thoracic esophageal squamous cell carcinoma (TESCC) and received neoadjuvant radiotherapy or chemoradiotherapy. Hazard ratios and 95% confidence intervals of categorical clinicopathological characteristics with overall survival (OS) were calculated using the Cox proportional hazard model. The nomogram and RPA model were then established and total scores according to each variable were calculated and stratified to predict OS. Results: Patients were followed-up over a median 49.9 months. AJCC did not perform well in distinguishing OS among each stage except for IIB and IIIA. Patients were divided into 4 groups according to the total scores based on nomogram (low risk: <= 180; intermediate risk: 180-270; high risk: 270-340; very high risk: >340). The 5-year OS was 57.3%, 40.7%, 18.3%, 6.1% respectively (p<0.05). RPA model also divide the patients into 4 groups, though group2 and group3 were not statistically significant (p=0.574). Conclusion: The nomogram is a good evaluation model for estimating the prognosis of patients with TESCC after neoadjuvant radiotherapy or chemoradiotherapy compared with the AJCC and RPA. The results of this study also suggested that the high-risk subgroups need further treatments.
引用
收藏
页码:41102 / 41112
页数:11
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