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

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Prognostic impact of examined lymph-node count for patients with esophageal cancer: development and validation prediction model

“…Through Lasso regression analysis, we identified sex, tumor site, T and N category, and number of retrieved nodes as independent prognostic factors. These findings were consistent with those of previous studies on survival risk factors for esophageal cancer 7 , 8 . Then, a Lasso-Cox model was constructed for predicting survival.…”

“…Surgical resection is considered the standard of care in the management of patients with EC 6 . With decades of widespread, multicenter, clinical research, the classification of malignant tumors based on the tumor-node-metastasis (TNM) staging system, developed by the American Joint Committee on Cancer (AJCC), as well as sex and pathological type, are approved as the conventional independent prognostic indicators for EC 7 , 8 . Additionally, dissection of lymph nodes is performed during resection, and the pathologic status of the lymph nodes (LNs) significantly affects postoperative survival.…”

A Clinical Prognostic Model Based on Preoperative Hematological and Clinical Parameters Predicts the Progression of Primary WHO Grade II Meningioma

“…However, most of these individualized medical treatments based on gene detection are invasive and expensive and cannot fully define the spatial heterogeneity of tumors. Numerous studies have demonstrated that hematological parameters have great potential in tumor prognostic stratification (7,9,(19)(20)(21); unlike genetic markers, hematological parameters obtained from preoperative peripheral blood tests have the advantages of non-invasiveness, low cost, and easy access. Previous studies have demonstrated that high preoperative levels of NLR and FIB and low levels of LMR are associated with adverse clinical outcomes of AM (7,11,22).…”

A novel nomogram for adult primary perihilar cholangiocarcinoma and considerations concerning lymph node dissection

“…The nomogram is a graphical representation of Logistic regression or Cox regression, which can be used to predict the probability of survival time of individual patients, with high accuracy and good clinical practicability. As an integrative and visualized predictive model, nomogram has been developed in a variety of cancers (14)(15)(16). Of note, the establishment of nomograms integrating conventional factors for pCCA has been noted in few studies.…”