Epidemiology and Prognostic Nomogram for Esophageal Cancer With Liver Metastasis Based on the Surveillance, Epidemiology, and End Results Database

Abstract

Background: The prognosis of esophageal cancer with liver metastasis (ECLM) is poor. This study evaluated the incidence and prognostic factors of ECLM at initial diagnosis and developed a visual nomogram to predict outcomes. Methods: 1892 eligible ECLM patients diagnosed between 2010 and 2016 were extracted from the Surveillance, Epidemiology, and End Results database (SEER). The incidence, patient overall survival (OS), and prognosis of liver metastasis were evaluated according to patient information, tumor characteristics, and therapy. Cox regression analyses were applied to evaluate prognostic factors. Based on the significant demographic and clinicopathologic factors, a novel visual nomogram was established to predict 6-month and 1-year survival for ECLM patients. Results: The incidence of ECLM increased with age, but survival rates showed the opposite trend. From 2010 to 2016, as age increased, the incidence also increased annually, peaking at age 70 to 79 years and then decreasing. The 1-, 3-, 6-, 9- and 12-month relative cancer survival rates for ECLM patients were 84.6%, 61.3%, 44.0%, 31.4%, and 21.8%, respectively. Multivariate cox regression analysis revealed that age, gender, grade, histological type, bone metastasis, lung metastasis, brain metastasis, chemotherapy and local treatment were independent prognostic factors related to OS. Moreover, our nomogram predicted the 6-month and 1-year survival times of the population, with a C-index of 0.735 (95% CI: 0.723-0.748). The nomogram demonstrated good clinical applicability. Conclusions: The incidence of ECLM increased with age, but survival rates showed the opposite trend. Age, gender, tumor characteristics, and therapy should be considered when predicting the prognosis of ECLM patients. The nomogram may improve clinicians’ abilities to predict individual survival and recommend treatments for ECLM patients.