Department of Radiotherapy, Jiangsu Cancer Hospital, Nanjing 210009, China.
Chin J Cancer Res. 2013 Oct;25(5):549-55. doi: 10.3978/j.issn.1000-9604.2013.10.05.
The aim of the present study was to construct a risk assessment model which was tested by disease-free survival (DFS) of esophageal cancer after radical surgery.
A total of 164 consecutive esophageal cancer patients who had undergone radical surgery between January 2005 and December 2006 were retrospectively analyzed. The cutpoint of value at risk (VaR) was inferred by stem-and-leaf plot, as well as by independent-samples t-test for recurrence-free time, further confirmed by crosstab chi-square test, univariate analysis and Cox regression analysis for DFS.
The cutpoint of VaR was 0.3 on the basis of our model. The rate of recurrence was 30.3% (30/99) and 52.3% (34/65) in VaR <0.3 and VaR ≥0.3 (chi-square test, (χ) (2) =7.984, P=0.005), respectively. The 1-, 3-, and 5-year DFS of esophageal cancer after radical surgery was 70.4%, 48.7%, and 45.3%, respectively in VaR ≥0.3, whereas 91.5%, 75.8%, and 67.3%, respectively in VaR <0.3 (Log-rank test, (χ) (2) =9.59, P=0.0020), and further confirmed by Cox regression analysis [hazard ratio =2.10, 95% confidence interval (CI): 1.2649-3.4751; P=0.0041].
The model could be applied for integrated assessment of recurrence risk after radical surgery for esophageal cancer.
本研究旨在构建一个风险评估模型,并用根治性手术后食管癌的无病生存率(DFS)进行验证。
回顾性分析 2005 年 1 月至 2006 年 12 月期间接受根治性手术的 164 例连续食管癌患者。通过茎叶图推断风险值(VaR)的切点,并通过复发无时间的独立样本 t 检验进一步证实,通过卡方检验、单因素分析和 COX 回归分析进行 DFS。
根据我们的模型,VaR 的切点为 0.3。VaR<0.3 和 VaR≥0.3 的复发率分别为 30.3%(30/99)和 52.3%(34/65)(卡方检验,(χ)(2)=7.984,P=0.005)。VaR≥0.3 组食管癌根治性手术后 1、3 和 5 年的 DFS 分别为 70.4%、48.7%和 45.3%,而 VaR<0.3 组分别为 91.5%、75.8%和 67.3%(Log-rank 检验,(χ)(2)=9.59,P=0.0020),并进一步通过 COX 回归分析证实[风险比=2.10,95%置信区间(CI):1.2649-3.4751;P=0.0041]。
该模型可用于综合评估食管癌根治性手术后的复发风险。