A Population-Based Study: How to Identify High-Risk T1–2 Esophageal Cancer Patients?

Abstract

BackgroundDue to individualized conditions of lymph node metastasis (LNM) and distant metastasis (DM), the following therapeutic strategy and diagnosis of T1–2 esophageal cancer (ESCA) patients are varied. A prediction model for identifying risk factors for LNM, DM, and overall survival (OS) of high-risk T1–2 ESCA patients is of great significance to clinical practice.MethodsA total of 1,747 T1–2 ESCA patients screened from the surveillance, epidemiology, and end results (SEER) database were retrospectively analyzed for their clinical data. Univariate and multivariate logistic regression models were established to screen out risk factors for LNM and DM of T1-2 ESCA patients, while those of OS were screened out using the Cox regression analysis. The identified risk factors for LNM, DM, and OS were then subjected to the establishment of three nomograms, respectively. The accuracy of the nomograms was evaluated by depicting the calibration curve, and the predictive value and clinical utility were evaluated by depicting the clinical impact curve (CIC) and decision curve analysis (DCA), respectively.ResultsThe age, race, tumor grade, tumor size, and T-stage were significant factors for predicting LNM of T1–2 ESCA patients (p < 0.05). The age, T-stage, tumor grade, and tumor size were significant factors for predicting DM of T1–2 ESCA patients (p < 0.05). The age, race, sex, histology, primary tumor site, tumor size, N-stage, M-stage, and surgery were significant factors for predicting OS of T1–2 ESCA patients (p < 0.05). The C-indexes of the three nomograms constructed by these factors were 0.737, 0.764, and 0.740, respectively, suggesting that they were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict the LNM, DM, and OS of T1–2 ESCA patients, which contribute to the individualized decision making before clinical management.

Nomogram models for the prognosis of cervical cancer: A SEER-based study

“…These indicated that our model was superior to the FIGO stage, providing greater net clinical benefit with a threshold probability between 0 and 90%. CIC analysis ( Figure 6 ) was performed to evaluate the clinical applicability of the risk prediction nomograms ( 18 , 19 ) and FIGO stage. The DCA and CICs showed that the nomograms had greater net benefit within wide and practical ranges of threshold probabilities and impacted patient outcomes, indicating that our models have a significant predictive value.…”

Systematic review and meta-analysis of endoscopic ultrasonography in staging diagnosis of esophageal cancer after neoadjuvant radiotherapy and chemotherapy

“…At present, the most commonly used methods for preoperative staging of esophageal cancer mainly include computed tomography (CT), endoscopic ultrasonography (EUS) and positron emission tomography (PET) (16)(17)(18)(19)(20)(21). Among them, CT, especially enhanced CT, is the most commonly used examination method to exclude distant metastasis of esophageal cancer patients, which can accurately find the most common liver, brain and lung metastasis (21,22).…”