Prognostic Nomogram for Thoracic Esophageal Squamous Cell Carcinoma after Radical Esophagectomy Runn

来源 :2014华东胸部肿瘤论坛暨第七届浙江省胸部肿瘤论坛 | 被引量 : 0次 | 上传用户:liujun87654
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  [Baekgroud] Nomogram has demonstrated its capability in individualized estimates of survival in diverse cancers.To date, however, no nomogram has been developed for ESCC.[Methods] We retrospectively investigated 1195 patients who underwent radical esophagectomy for ESCC at Zhejiang Cancer Hospital in Hangzhou, China.We randomly assigned two-thirds of the patients to a training cohort (n=797) and one-third to a validation cohort (n=398).Cox proportional hazards regression analysezis were performed using the training cohort,and a nomogram was constructed for predicting 3-year and 5-year overall survival.The discriminative ability of the nomogram was determined by the concordance index (Cindex) and calibration plot.The predictive accuracy of the nomogram was compared to that of the sixth and seventh editions of the TNM staging system according to the C-index.[Results] Multivariate analysis identified tumor length, surgical approach, number of examined lymph node, number of positive lymph node,extent of positive lymph node,grade,and depth of invasion as independent risk factors for survival.External validation shows that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.715,95%CI=0.671~0.759).Calibration curve demonstrates that the nomogram predicted survival was in good agreement with the actual observation.The C-index of the nomogram was significantly higher than that of the sixth edition (0.664,P-value<0.0001) and the seventh edition (0.696, P-value<0.0003) of the TNM classification.[Conclusion] This study developed the first nomogram for ESCC that can be applied in daily clinical practice for individualized survival prediction.
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