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. 2024 Oct 31;16(10):6452-6461.
doi: 10.21037/jtd-24-742. Epub 2024 Oct 21.

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

Xiaomei Li #  1 , Daosheng Li #  1 , Shuming Qin  1 , Hong Ye  1 , Min Lin  1
Affiliations

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

Xiaomei Li et al. J Thorac Dis. .

Abstract

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.

Keywords: Esophageal cancer (EC); Surveillance, Epidemiology and End Results (SEER); long-term survival; lymphadenectomy; nomogram.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-742/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Nomograms for 3-, 5-, and 8-year OS in training cohort. OS, overall survival.
Figure 2
Figure 2
Time-dependent ROC curves and AUC for 3-, 5-, and 8-year OS in training cohort (A) and validation cohort (B). ROC, receiver operating characteristic; AUC, area under the ROC curve; OS, overall survival.
Figure 3
Figure 3
Calibration curves of 3-, 5-, and 8-year OS in the training cohort (A-C) and the validation cohort (D-F), respectively. OS, overall survival.
Figure 4
Figure 4
Kaplan-Meier OS curves of the low- and high-risk EC patients stratified by nomograms in the training cohort (A) and validation cohort (B). EC, esophageal cancer; OS, overall survival.
See this image and copyright information in PMC

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