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. 2016 May 24:6:26684.
doi: 10.1038/srep26684.

Clinical Nomogram for Predicting Survival of Esophageal Cancer Patients after Esophagectomy

Jinlin Cao  1 , Ping Yuan  1 , Luming Wang  1 , Yiqing Wang  1 , Honghai Ma  1 , Xiaoshuai Yuan  1 , Wang Lv  1 , Jian Hu  1
Affiliations

Clinical Nomogram for Predicting Survival of Esophageal Cancer Patients after Esophagectomy

Jinlin Cao et al. Sci Rep. .

Abstract

The aim of this study was to construct an effective clinical nomogram for predicting the survival of esophageal cancer patients after esophagectomy. We identified esophageal cancer patients (n = 4,281) who underwent esophagectomy between 1988 and 2007 from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Clinically significant parameters for survival were used to construct a nomogram based on Cox regression analyses. The model was validated using bootstrap resampling and a Chinese cohort (n = 145). A total of 4,109 patients from the SEER database were included for analysis. The multivariate analyses showed that the factors of age, race, histology, tumor site, tumor size, grade and depth of invasion, and the numbers of metastases and retrieved nodes were independent prognostic factors. All of these factors were selected into the nomogram. The nomogram showed a clear prognostic superiority over the seventh AJCC-TNM classification (C-index: SEER cohort, 0.716 vs 0.693, respectively; P < 0.01; Chinese cohort, 0.699 vs 0.680, respectively; P < 0.01). Calibration of the nomogram predicted the probabilities of 3- and 5-year survival, which corresponded closely with the actual survival rates. This novel prognostic model may improve clinicians' abilities to predict individualized survival and to make treatment recommendations.

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Figures

Figure 1
Figure 1. Nomogram predicting 3- and 5-year survival after esophagectomy for esophageal cancer.
AD, adenocarcinoma; SCC, squamous cell carcinoma. The X category is used when information on a specific component is unknown.
Figure 2
Figure 2
The calibration curves for predicting patient survival at (A) 3-year and (B) 5-year in the training cohort, and at (C) 3-year and (D) 5-year in the validation cohort. Nomogram-predicted survival is plotted on the x-axis; actual survival is plotted on the y-axis.
Figure 3
Figure 3. X-tile analysis of survival based on risk scores.
Figure 4
Figure 4
Kaplan-Meier survival curves for patients with esophageal cancer by risk group stratification within each TNM stage ((A,B), all patients; (C–I) stages) in the training cohort. Subgroups with fewer than 12 patients were omitted from the graphs.
See this image and copyright information in PMC

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