Nomogram model for predicting long-term survival in esophageal cancer patients with metastasis after treatment: a SEER-based study.

BACKGROUND

There is a large variance in the long-term survival of esophageal cancer (EC) patients with metastasis after treatment. This study was designed to analyze long-term survival of metastatic EC patients after surgery, radiotherapy and chemotherapy.

METHODS

A retrospective cohort of EC patients with metastasis received surgery, radiotherapy and chemotherapy from 2004 to 2015 was obtained from the Surveillance, Epidemiology and End Results (SEER) database. Univariate Cox and complete subset regression analyses were performed to select prognostic factors. Nomograms were established to predict 3-, 5-, and 8-year overall survival (OS), and their performance was evaluated by receiver operating characteristic (ROC) curve and calibration curve.

RESULTS

Age at diagnosis [hazard ratio (HR): 1.01; 95% confidence interval (CI): 1.00, 1.02; P=0.04], EC of other sites (HR: 1.78; 95% CI: 1.29, 2.45; P<0.001), lymph node involvement (HR: 1.37; 95% CI: 1.08, 1.37; P=0.009), and poorly differentiated or undifferentiated (grade III or IV) (HR: 1.39; 95% CI: 1.20, 1.76; P=0.006) was the independent risk factors for poor OS in EC patients. Female (HR: 0.58; 95% CI: 0.38, 0.88; P=0.01) showed reduced risks of showing poor OS compared with male population. The established nomograms based on these predictors showed satisfactory discrimination efficacy for predicting 3-, 5-, and 8-year OS in metastatic EC patients after treatment.

CONCLUSIONS

The nomograms showed good efficacy in predicting 3-, 5-, and 8-year OS among metastatic EC patients after surgery, radiotherapy and chemotherapy.