Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, Beijing Chuiyangliu Hospital, Chuiyangliu Hospital Affiliated to Tsinghua University, Beijing, China.
Thorac Cancer. 2022 Nov;13(21):2960-2969. doi: 10.1111/1759-7714.14642. Epub 2022 Sep 28.
This retrospective study aimed to explore risk factors for liver metastases (LiM) in patients with esophageal cancer (EC) and to identify prognostic factors in patients initially diagnosed with LiM.
A total of 28 654 EC patients were retrieved from the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. A multivariate logistic regression model was utilized to identify risk factors for LiM. A Cox regression model was used to identify prognostic factors for patients with LiM.
Of 28 654 EC patients, 4062 (14.2%) had LiM at diagnosis. The median overall survival (OS) for patients with and without LiM was 6.00 (95% CI: 5.70-6.30) months and 15.00 (95% CI: 14.64-15.36) months, respectively. Variables significantly associated with LiM included gender, age, tumor site, histology, tumor grade, tumor size, clinical T stage, clinical N stage, bone metastases (BoM), brain metastases (BrM) and lung metastases (LuM). Variables independently predicting survival for EC patients with LiM were age, histology, tumor grade, BoM, BrM, LuM, and chemotherapy. A risk prediction model and two survival prediction models were then constructed revealing satisfactory predictive accuracy.
Based on the largest known cohort of EC, independent predictors of LiM and prognostic indicators of survival for patients with LiM were identified. Two models for predicting survival as well as a risk prediction model were developed with robust predictive accuracy.
本回顾性研究旨在探讨食管癌（EC）患者肝转移（LiM）的危险因素，并确定初诊 LiM 患者的预后因素。
从 2010 年至 2018 年，从监测、流行病学和最终结果（SEER）数据库中检索了 28654 例 EC 患者。利用多变量逻辑回归模型确定 LiM 的危险因素。利用 Cox 回归模型确定 LiM 患者的预后因素。
在 28654 例 EC 患者中，4062 例（14.2%）在诊断时发生 LiM。有 LiM 和无 LiM 的患者的中位总生存期（OS）分别为 6.00（95%CI：5.70-6.30）个月和 15.00（95%CI：14.64-15.36）个月。与 LiM 显著相关的变量包括性别、年龄、肿瘤部位、组织学、肿瘤分级、肿瘤大小、临床 T 分期、临床 N 分期、骨转移（BoM）、脑转移（BrM）和肺转移（LuM）。独立预测 LiM 患者 EC 生存的变量为年龄、组织学、肿瘤分级、BoM、BrM、LuM 和化疗。然后构建了风险预测模型和两个生存预测模型，均显示出令人满意的预测准确性。
基于已知最大的 EC 队列，确定了 LiM 的独立预测因素和 LiM 患者的生存预后指标。开发了两种具有稳健预测准确性的生存预测模型和一个风险预测模型。
