Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, WenZhou, China.
BMC Cancer. 2018 Sep 10;18(1):879. doi: 10.1186/s12885-018-4796-5.
BACKGROUND: The aim of this study was to develop nomograms for predicting the risk of locoregional recurrence or distant metastasis in esophageal cancer patients who were treated with esophagectomy and regional lymphadenectomy. METHODS: The clinicopathologic data of 408 esophageal cancer patients after esophagectomy and regional lymphadenectomy were analyzed in this study. Univariate and multivariate COX regression analyses were used to test the association between the clinicopathologic data and the risk of locoregional recurrence or distant metastasis. The nomograms were built from the COX regression model. RESULTS: Univariate analyses revealed that tumor length, tumor width, T-staging and perineural invasion(PNI) were significantly associated with locoregional recurrence, and that tumor length, tumor width, differentiation, T-staging, N-staging, lymph vascular space invasion(LVSI), PNI and adjuvant chemotherapy were significantly associated with distant metastasis. Multivariate analyses revealed that tumor length, tumor width and T-staging were predictors of risk of locoregional recurrence, and that differentiation, N-staging, LVSI and PNI were predictors of risk of distant metastasis. Two nomograms were constructed for a visual explanation of these two COX regression models. The bias-corrected curve showed no significant departure from the ideal curve in these two nomograms. CONCLUSIONS: Two nomograms were developed and validated to predict the risk of locoregional recurrence and distant metastasis in esophageal cancer patients after radical esophagectomy. The calculation outcome will help oncologists to choose adjuvant treatment regimens.
背景:本研究旨在为接受食管癌根治性切除术和区域淋巴结清扫术的食管癌患者建立预测局部区域复发或远处转移风险的列线图。
方法:本研究分析了 408 例食管癌根治性切除术和区域淋巴结清扫术后患者的临床病理资料。采用单因素和多因素 COX 回归分析检测临床病理数据与局部区域复发或远处转移风险之间的关系。从 COX 回归模型中构建列线图。
结果:单因素分析显示,肿瘤长度、肿瘤宽度、T 分期和神经周围侵犯(PNI)与局部区域复发显著相关,而肿瘤长度、肿瘤宽度、分化、T 分期、N 分期、淋巴血管空间侵犯(LVSI)、PNI 和辅助化疗与远处转移显著相关。多因素分析显示,肿瘤长度、肿瘤宽度和 T 分期是局部区域复发风险的预测因素,而分化、N 分期、LVSI 和 PNI 是远处转移风险的预测因素。构建了两个列线图来直观解释这两个 COX 回归模型。偏倚校正曲线显示这两个列线图均未明显偏离理想曲线。
结论:本研究建立并验证了两个列线图,以预测食管癌根治性切除术后患者的局部区域复发和远处转移风险。计算结果将有助于肿瘤学家选择辅助治疗方案。
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