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Nomogram to Predict Overall Survival for Thoracic Esophageal Squamous Cell Carcinoma Patients After Radical Esophagectomy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Effective tools evaluating the prognosis for patients with esophageal cancer undergoing surgery is lacking. The current study aimed to develop a nomogram to predict overall survival (OS) and provide evidence for adjuvant therapy for patients with esophageal carcinoma after esophagectomy.

Methods

The study retrospectively reviewed patients with pathologic T1N +/T2-4aN0-3, M0 thoracic esophageal squamous cell carcinoma after radical esophagectomy, with or without adjuvant therapy, in one institution as the training cohort (n = 2281). A nomogram was established using Cox proportional hazard regression to identify prognostic factors for OS, which were validated in an independent validation cohort (n = 1437). Area under curve (AUC) values of receiver operating characteristic curves were calculated to evaluate prognostic efficacy.

Results

In the training cohort, the median OS was 50.46 months, and the 5-year OS rate was 47.08%. Adjuvant therapy, sex, tumor location, grade, lymphovascular invasion, removed lymph nodes, and T and N categories were identified as predictive factors for OS. The nomogram showed favorable prognostic efficacy in the training and validation cohorts (5-year OS AUC: 0.685 and 0.744, respectively), which was significantly higher than that of the American Joint Committee on Cancer (AJCC) staging system. The nomogram distinguished OS rates among six risk groups, whereas AJCC could not separate the OS of 2A and 1B, 3C and 3B, or 3A and 2B. Patients with a nomogram score of 72 to 227 were predicted to achieve a 5-year OS increase of 10% or more from adjuvant therapy.

Conclusion

The nomogram could effectively predict OS and aided decision making in adjuvant therapy for patients with thoracic esophageal squamous cell carcinoma after esophagectomy.

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Acknowledgment

This work was supported by the Capital Clinical Characteristic Application Research of China (Z121107001012004), the Capital Health Research and Development of Special of China (2016-2-4021), and the National Key Projects of Research and Development of China (2016YFC0904600).

Disclosure

Junqiang Chen has research funding from the Key Clinical Specialty Discipline Construction Program of Fujian, P.R.C. All the other authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Wei Deng MD, Wenjie Ni MD, Chen Li MD, Xiao Chang MD, Zongmei Zhou MD, Dongfu Chen MD, Qinfu Feng MD & Zefen Xiao MD

  2. Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention Therapy, Tianjin, China

    Wencheng Zhang MD

  3. Department of Radiation Oncology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China

    Jinsong Yang MD

  4. Department of Radiation Oncology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

    Shufei Yu MD

  5. Department of Thoracic Surgery, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China

    Xiaohui Chen MD & Kunshou Zhu MD

  6. Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China

    Yu Lin MD & Junqiang Chen MD

  7. Department of Pathology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China

    Xiongwei Zheng MD

  8. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Jie He MD, Shugeng Gao MD, Qi Xue MD, Yousheng Mao MD, Guiyu Cheng MD, Kelin Sun MD, Xiangyang Liu MD & Dekang Fang MD

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Correspondence to Junqiang Chen MD or Zefen Xiao MD.

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Deng, W., Zhang, W., Yang, J. et al. Nomogram to Predict Overall Survival for Thoracic Esophageal Squamous Cell Carcinoma Patients After Radical Esophagectomy. Ann Surg Oncol 26, 2890–2898 (2019). https://doi.org/10.1245/s10434-019-07393-w

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