Department of Surgery, Amsterdam University Medical Centres, Location AMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands.
Department of Radiotherapy, Amsterdam University Medical Centres, Location AMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands.
Br J Surg. 2020 Jul;107(8):1053-1061. doi: 10.1002/bjs.11476. Epub 2020 Feb 3.
Conditional survival accounts for the time already survived after surgery and may be of additional informative value. The aim was to assess conditional survival in patients with oesophageal cancer and to create a nomogram predicting the conditional probability of survival after oesophagectomy.
This retrospective study included consecutive patients with oesophageal cancer who received neoadjuvant chemoradiation followed by oesophagectomy between January 2004 and 2019. Conditional survival was defined as the probability of surviving y years after already surviving for x years. The formula used for conditional survival (CS) was: CS = S /S , where S represents overall survival at x years. Cox proportional hazards models were used to evaluate predictors of overall survival. A nomogram was constructed to predict 5-year survival directly after surgery and given survival for 1, 2, 3 and 4 years after surgery.
Some 660 patients were included. Median overall survival was 44·4 (95 per cent c.i. 37·0 to 51·8) months. The probability of achieving 5-year overall survival after resection increased from 45 per cent directly after surgery to 54, 65, 79 and 88 per cent given 1, 2, 3 and 4 years already survived respectively. Cardiac co-morbidity, cN category, ypT category, ypN category, chyle leakage and pulmonary complications were independent predictors of survival. The nomogram predicted 5-year survival using these predictors and number of years already survived.
The probability of achieving 5-year overall survival after oesophagectomy for cancer increases with each additional year survived. The proposed nomogram predicts survival in patients after oesophagectomy, taking the years already survived into account.
条件生存考虑了手术后已经存活的时间，可能具有额外的信息价值。目的是评估食管癌患者的条件生存，并创建一个预测食管癌手术后条件生存概率的列线图。
本回顾性研究纳入了 2004 年 1 月至 2019 年间接受新辅助放化疗后行食管癌切除术的连续食管癌患者。条件生存定义为已经存活 x 年后再存活 y 年的生存概率。条件生存（CS）的计算公式为：CS=S/S，其中 S 代表 x 年时的总生存。Cox 比例风险模型用于评估总生存的预测因素。构建了一个列线图来直接预测手术后 5 年的生存率，并预测手术后 1、2、3 和 4 年的生存率。
共纳入 660 例患者。中位总生存时间为 44.4（95%可信区间 37.0 至 51.8）个月。切除后达到 5 年总生存率的概率从手术后直接的 45%增加到分别已经存活 1、2、3 和 4 年时的 54%、65%、79%和 88%。心脏合并症、cN 分期、ypT 分期、ypN 分期、乳糜漏和肺部并发症是生存的独立预测因素。该列线图使用这些预测因素和已经存活的年数来预测 5 年生存率。
食管癌手术后达到 5 年总生存率的概率随着每年存活时间的增加而增加。该列线图考虑了已经存活的年数，预测了食管癌手术后患者的生存率。
