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寡转移食管癌患者列线图预后模型的建立与验证。

Development and validation of a nomogram prognostic model for esophageal cancer patients with oligometastases.

机构信息

National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.

Department of Radiation Oncology, Tianjin Medical University, Tianjin, 300070, China.

出版信息

Sci Rep. 2020 Jul 9;10(1):11259. doi: 10.1038/s41598-020-68160-6.

Abstract

Platinum-based chemotherapy is recommended as the standard treatment for metastatic esophageal cancer (EC) patients; however, the outcome is poor. Oligometastasis is less aggressive and has limited growth potential. However, the prognostic factors for EC patients with oligometastases was largely unknown. Thus, we intend to determine the prognostic factors, and develop and validate nomograms for prediction of survival for EC patients with oligometastases. In this study, characteristics of 273 oligometastatic EC patients were analyzed using univariate and multivariate Cox models to determine the independent prognostic factors for progression-free survival (PFS) and overall survival (OS). The result showed that history of alcohol consumption, longer tumor, no local radiotherapy for EC, and no local treatment for metastases were independent factors for PFS. Sex, esophageal fistula, number of metastatic organs, and local radiotherapy for EC were independent prognostic factors for OS. On the basis of Cox models, the respective nomogram for prediction of PFS and OS was established with the corrected concordance index of 0.739 and 0.696 after internal cross-validation. In conclusion, local treatment for metastases and local radiotherapy for EC were demonstrated to be beneficial for oligometastatic EC patients, and the validated nomograms are valuable in prognosis prediction and could guide individualized management for these patients.

摘要

铂类化疗被推荐为转移性食管癌(EC)患者的标准治疗方法;然而,其治疗效果较差。寡转移的侵袭性较低,生长潜力有限。然而,EC 寡转移患者的预后因素在很大程度上是未知的。因此,我们旨在确定 EC 寡转移患者的预后因素,并开发和验证用于预测生存的列线图。在这项研究中,我们使用单因素和多因素 Cox 模型分析了 273 例寡转移性 EC 患者的特征,以确定无进展生存期(PFS)和总生存期(OS)的独立预后因素。结果表明,饮酒史、较长的肿瘤、EC 无局部放疗和转移灶无局部治疗是 PFS 的独立因素。性别、食管瘘、转移器官数量和 EC 的局部放疗是 OS 的独立预后因素。基于 Cox 模型,在内部交叉验证后,分别建立了用于预测 PFS 和 OS 的列线图,校正后的一致性指数分别为 0.739 和 0.696。总之,转移灶的局部治疗和 EC 的局部放疗对寡转移 EC 患者有益,验证后的列线图在预后预测方面具有价值,并可指导这些患者的个体化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3c/7347928/ba54fc46d7b7/41598_2020_68160_Fig1_HTML.jpg

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