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Construction and validation of a risk-scoring model to predict lymph node metastasis in T1b–T2 esophageal cancer

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Abstract

Background

Lymph node status is an important factor in determining preoperative treatment strategies for stage T1b–T2 esophageal cancer (EC). Thus, the aim of this study was to investigate the risk factors for lymph node metastasis (LNM) in T1b–T2 EC and to establish and validate a risk-scoring model to guide the selection of optimal treatment options.

Methods

Patients who underwent upfront surgery for pT1b–T2 EC between January 2016 and December 2022 were analyzed. On the basis of the independent risk factors determined by multivariate logistic regression analysis, a risk-scoring model for the prediction of LNM was constructed and then validated. The area under the receiver operating characteristic curve (AUC) was used to assess the discriminant ability of the model.

Results

The incidence of LNM was 33.5% (214/638) in our cohort, 33.4% (169/506) in the primary cohort and 34.1% (45/132) in the validation cohort. Multivariate analysis confirmed that primary site, tumor grade, tumor size, depth, and lymphovascular invasion were independent risk factors for LNM (all P < 0.05), and patients were grouped based on these factors. A 7-point risk-scoring model based on these variables had good predictive accuracy in both the primary cohort (AUC, 0.749; 95% confidence interval 0.709–0.786) and the validation cohort (AUC, 0.738; 95% confidence interval 0.655–0.811).

Conclusion

A novel risk-scoring model for lymph node metastasis was established to guide the optimal treatment of patients with T1b–T2 EC.

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Funding

This study was supported by the Science and Technology Program of Fujian Province, China (2021J01442).

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Authors and Affiliations

  1. Department of Thoracic Oncology Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350001, Fujian, China

    Jun-Peng Lin, Xiao-Feng Chen, Wei-Jie Chen, Pei-Yuan Wang, Hao He, Feng-Nian Zhuang, Hang Zhou, Yu-Jie Chen, Wen-Wei Wei, Shuo-Yan Liu & Feng Wang

  2. Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China

    Jun-Peng Lin, Xiao-Feng Chen, Wei-Jie Chen, Pei-Yuan Wang, Hao He, Feng-Nian Zhuang, Hang Zhou, Yu-Jie Chen, Wen-Wei Wei, Shuo-Yan Liu & Feng Wang

  3. Fujian Provincial Key Laboratory of Tumor Biotherapy, Fuzhou, China

    Jun-Peng Lin, Xiao-Feng Chen, Wei-Jie Chen, Pei-Yuan Wang, Hao He, Feng-Nian Zhuang, Hang Zhou, Yu-Jie Chen, Wen-Wei Wei, Shuo-Yan Liu & Feng Wang

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  1. Jun-Peng Lin
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Contributions

J-PL, S-YL, FW, and X-FC: contributed to the conception and design. J-PL, W-JC, P-YW, HZ, and F-NZ: collected and analyzed the data. J-PL, Y-JC, W-WW, and HH: drew the figures and tables. J-PL: wrote the draft. J-PL, W-JC, FW, and S-YL: contributed to manuscript writing and revision. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Shuo-Yan Liu or Feng Wang.

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Disclosures

Authors Jun-Peng Lin, Xiao-Feng Chen, Wei-Jie Chen, Pei-Yuan Wang, Hao He, Feng-Nian Zhuang, Hang Zhou, Yu-Jie Chen, Wen-Wei Wei, Shuo-Yan Liu, and Feng Wang have no conflicts of interest or financial ties to disclose.

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Lin, JP., Chen, XF., Chen, WJ. et al. Construction and validation of a risk-scoring model to predict lymph node metastasis in T1b–T2 esophageal cancer. Surg Endosc 38, 640–647 (2024). https://doi.org/10.1007/s00464-023-10565-1

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