Models for Predicting Early Death in Patients With Stage IV Esophageal Cancer: A Surveillance, Epidemiology, and End Results–Based Cohort Study

Shi, Min; Zhai, Gangyi

doi:10.1177/10732748211072976

Cited by 11 publications

(11 citation statements)

References 41 publications

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“…Similar to the findings in previous studies, female had a better OS in EC patients receiving nCT. Shi et al found that tumor pathologic stage is an early death of patients with stage IV esophageal independent risk factors ( 25 ). This study indicated that EC patients receiving nCT with higher pathologic stage had a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram model to predict the overall survival rate of esophageal cancer patients receiving neoadjuvant chemotherapy: A population-based study

Yang

2023

Front. Surg.

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IntroductionThe development of neoadjuvant chemotherapy(nCT) improves the overall survival (OS) of patients with esophageal cancer(EC). The aim of this study was to determine the independent prognostic factors of EC patients receiving nCT, and to construct a nomogram model for predicting OS.MethodThis retrospective analysis was conducted from the National Cancer Institute's Surveillance Epidemiology and End Results, Clinicopathological data of patients with EC who received nCT from 2004 to 2015. The included patients were randomly divided into the training cohort and the validation cohort. Univariate and multivariate Cox proportional hazards models were used to analyze the patients in the training cohort to determine the independent prognostic factors. Based on the independent prognostic variables, nomogram models for 1-year, 2-year and 3-year OS were constructed. The receiver operating characteristic (ROC) and area under curve (AUC) were used to evaluate the discriminative ability. The calibration curves, decision curve analysis (DCA) and Kaplan-Meier (K-M) survival analysis were used to evaluate the predictive accuracy and clinical application value.ResultsA total of 2,493 patients were enrolled, with 1,748 patients in the training cohort and 745 patients in the validation cohort. Gender, marital status, tumor pathological grade, T stage, N stage, and M stage were identified as independent prognostic factor (P < 0.05). A novel nomogram model was constructed. ROC curve analysis revealed that the model had moderate predictive performance, which was better than that of the AJCC TNM staging system.The calibration curves showed a high agreement between the actual observed values and the predicted values. The DCA suggested that the newly constructed prediction model had good clinical application value. K-M survival analysis showed that the model was helpful to accurately distinguish the prognosis of patients with different risk levels.ConclusionsGender, tumor pathological grade, marital status, T stage, N stage and M stage were identified as independent prognostic factors for overall survival of patients with esophageal cancer who received neoadjuvant chemotherapy. A nomogram prediction model was established, which was helpful to accurately and reliably predict the overall survival rate of patients with esophageal cancer who received neoadjuvant chemotherapy at 1, 2 and 3 years.

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Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram model to predict the overall survival rate of esophageal cancer patients receiving neoadjuvant chemotherapy: A population-based study

Yang

2023

Front. Surg.

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“…The reason may be that elderly patients has a higher incidence of comorbidities, which may result higher risk of cardiovascular events, but the specific mechanism still needs further analysis. In addition, multivariate competitive risk analysis suggested that EC patients with poorly and undifferentiated (HR: 0.843; 95% CI: 0.757-0.938) and distant tumor stage (HR: 0.315; 95% CI: 0.271-0.366) has lower risk of CVD related death, low degree of differentiation and distant stage are adverse prognostic factors of EC patients (27,28), since the proportion of CVD related death increased with the increase in years of diagnosis, leading to the possibility that these patients may not have a long enough life expectancy to died from CVD. Married patients showed a lower tendency to died from CVD than unmarried patients (HR: 0.883; 95% CI: 0.797-0.978), they often receive more physical and emotional care, encouragement and support than unmarried patients (29), that could be one of the reason.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular disease related death among patients with esophagus cancer: A population-based competing risk analysis

et al. 2022

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The proportion of non-cancer death in patients with esophagus cancer (EC) still increasing, especially cardiovascular disease (CVD) related death. The aim of this study was assess non-cancer causes of death and identified independent risk factors of CVD related death in EC patients. Patients diagnosed with EC were extracted from the Surveillance, Epidemiology, and End Result database (SEER) database for analysis. Standardized mortality rates (SMRs) for non-EC deaths were calculated, the risk of death were assessed and compared with US general population. Multivariate competitive risk analysis were performed to select independent risk factors for death from CVD in EC patients. A total of 43739 EC patients were enrolled and 35139 died during follow-up, of which 4248 died from non-cancer cause of death. The risk of non-cancer death in EC patients was 2.27-fold higher than in the general population (SMR=2.27; 95% CI, 2.20-2.34). CVD were the most important cause of non-cancer death in EC patients, accounting for 43.4% of non-cancer of deaths. Compare with the general population, EC patients have higher risk of death from disease of heart (SMR, 2.24; 95% CI, 2.13-2.35), pneumonia and influenza (SMR, 2.92; 95% CI, 2.50-3.39), septicemia (SMR, 5.01; 95% CI, 4.30-5.79), along with other causes. Patients with advanced age and patients who received radiotherapy has higher risk of death caused by CVD, patients with female sex, poor differentiated and undifferentiated, regional and distant stage, married, diagnosed between 2010-2016 has lower risk of CVD related death, compared with patients without any treatment measures, patients received chemotherapy alone has lower risk of death from CVD. Non-cancer cause of death has become an important cause of death in EC patients. Improving public awareness of the major risk factors for non-cancer death is beneficial to the prevention and treatment of malignant tumors.

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“…In recent years, predictive factors associated with early mortality in malignant tumors such as breast, liver, nasopharyngeal, esophageal, and gastric cancers have been reported. [10][11][12][13][14]19] However, there are fewer studies on early mortality in elderly SCLC patients.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, early death (defined as death occurring within 3 months after initial diagnosis) of cancer patients is a very objective clinical feature revealing the aggressiveness of cancer. Researchers have reported predictive factors associated with early death in malignancies such as breast, liver, nasopharyngeal, esophageal, and gastric cancers, [10][11][12][13][14] however, risk factors for early death in elderly SCLC patients remain unreported.…”

Section: Introductionmentioning

confidence: 99%

A practical nomogram for predicting early death in elderly small cell lung cancer patients: A SEER-based study

Chen,

Liu,

Tou

et al. 2024

Medicine

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This study aimed to identify risk factors for early death in elderly small cell lung cancer (SCLC) patients and develop nomogram prediction models for all-cause and cancer-specific early death to improve patient management. Data of elderly patients diagnosed with SCLC were extracted from the SEER database, then randomly divided into training and validation cohorts. Univariate and stepwise multivariable Logistic regression analyses were performed on the training cohort to identify independent risk factors for early death in these patients. Nomograms were developed based on these factors to predict the overall risk of early death. The efficacy of the nomograms was validated using various methods, including ROC analysis, calibration curves, DCA, NRI, and IDI. Among 2077 elderly SCLC patients, 773 died within 3 months, 713 due to cancer-specific causes. Older age, higher AJCC staging, brain metastases, and lack of surgery, chemotherapy, or radiotherapy increase the risk of all-cause early death, while higher AJCC staging, brain metastases, lung metastases, and lack of surgery, chemotherapy, or radiotherapy increase the risk of cancer-specific death (P < .05). These identified factors were used to construct 2 nomograms to predict the risk of early death. The ROC indicated that the nomograms performed well in predicting both all-cause early death (AUC = 0.823 in the training cohort and AUC = 0.843 in the validation cohort) and cancer-specific early death (AUC = 0.814 in the training cohort and AUC = 0.841 in the validation cohort). The results of calibration curves, DCAs, NRI and IDI also showed that the 2 sets of nomograms had good predictive power and clinical utility and were superior to the commonly used TNM staging system. The nomogram prediction models constructed in this study can effectively assist clinicians in predicting the risk of early death in elderly SCLC patients, and can also help physicians screen patients at higher risk and develop personalized treatment plans for them.

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Models for Predicting Early Death in Patients With Stage IV Esophageal Cancer: A Surveillance, Epidemiology, and End Results–Based Cohort Study

Cited by 11 publications

References 41 publications

Construction and validation of a nomogram model to predict the overall survival rate of esophageal cancer patients receiving neoadjuvant chemotherapy: A population-based study

Construction and validation of a nomogram model to predict the overall survival rate of esophageal cancer patients receiving neoadjuvant chemotherapy: A population-based study

Cardiovascular disease related death among patients with esophagus cancer: A population-based competing risk analysis

A practical nomogram for predicting early death in elderly small cell lung cancer patients: A SEER-based study

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