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Prognostic Nomogram for Thoracic Esophageal Squamous Cell Carcinoma after Radical Esophagectomy.

Su D, Zhou X, Chen Q, Jiang Y, Yang X, Zheng W, Tao K, Wu J, Yan Z, Liu L, Wu S, Mao W - PLoS ONE (2015)

Bottom Line: Multivariate analysis identified tumor length, surgical approach, number of examined lymph node, number of positive lymph node, extent of positive lymph node, grade, and depth of invasion as independent risk factors for survival.The discriminative ability of the nomogram was externally determined using the validation cohort, showing that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.715, 95% CI 0.671-0.759).The C-index of the nomogram was significantly higher than that of the sixth edition (0.664, P-value < 0.0001) and the seventh edition (0.696, P-value < 0.0003) of the TNM classification.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Institute, Zhejiang Cancer Hospital & Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology of Zhejiang Province, Hangzhou, China.

ABSTRACT
Nomogram has demonstrated its capability in individualized estimates of survival in diverse cancers. Here we retrospectively investigated 1195 patients with esophageal squamous-cell carcinoma (ESCC) who underwent radical esophagectomy at Zhejiang Cancer Hospital in Hangzhou, China. We randomly assigned two-thirds of the patients to a training cohort (n = 797) and one-third to a validation cohort (n = 398). Cox proportional hazards regression analyses were performed using the training cohort, and a nomogram was developed for predicting 3-year and 5-year overall survival rates. Multivariate analysis identified tumor length, surgical approach, number of examined lymph node, number of positive lymph node, extent of positive lymph node, grade, and depth of invasion as independent risk factors for survival. The discriminative ability of the nomogram was externally determined using the validation cohort, showing that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.715, 95% CI 0.671-0.759). The C-index of the nomogram was significantly higher than that of the sixth edition (0.664, P-value < 0.0001) and the seventh edition (0.696, P-value < 0.0003) of the TNM classification. This study developed the first nomogram for ESCC, which can be applied in daily clinical practice for individualized survival prediction.

No MeSH data available.


Related in: MedlinePlus

Distribution of the nomogram predicted 5-year survival according to (A) the sixth edition, and (B) the seventh edition of the TNM staging system.The predicted survival probabilities in each of the TNM stages exhibit a wide range of variation.
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pone.0124437.g004: Distribution of the nomogram predicted 5-year survival according to (A) the sixth edition, and (B) the seventh edition of the TNM staging system.The predicted survival probabilities in each of the TNM stages exhibit a wide range of variation.

Mentions: Fig 3 illustrates that in the training cohort, both the sixth and seventh editions of the AJCC TNM system were able to stratify patients from stage II to all the later stages, but failed to distinguish patients from stage I to stages II and stage III. Fig 4 illustrates the 5-year survival predicted by the nomogram in the training cohort for each stage of the sixth and seventh editions of the AJCC TNM system. The overall survival predicted by the nomogram was distinctive in each of the TNM stages, the higher the stages and the lower the survival of the patients. Within each of the stages, however, the survival rates show a wide range of variations, and overlap with adjacent stages.


Prognostic Nomogram for Thoracic Esophageal Squamous Cell Carcinoma after Radical Esophagectomy.

Su D, Zhou X, Chen Q, Jiang Y, Yang X, Zheng W, Tao K, Wu J, Yan Z, Liu L, Wu S, Mao W - PLoS ONE (2015)

Distribution of the nomogram predicted 5-year survival according to (A) the sixth edition, and (B) the seventh edition of the TNM staging system.The predicted survival probabilities in each of the TNM stages exhibit a wide range of variation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4404051&req=5

pone.0124437.g004: Distribution of the nomogram predicted 5-year survival according to (A) the sixth edition, and (B) the seventh edition of the TNM staging system.The predicted survival probabilities in each of the TNM stages exhibit a wide range of variation.
Mentions: Fig 3 illustrates that in the training cohort, both the sixth and seventh editions of the AJCC TNM system were able to stratify patients from stage II to all the later stages, but failed to distinguish patients from stage I to stages II and stage III. Fig 4 illustrates the 5-year survival predicted by the nomogram in the training cohort for each stage of the sixth and seventh editions of the AJCC TNM system. The overall survival predicted by the nomogram was distinctive in each of the TNM stages, the higher the stages and the lower the survival of the patients. Within each of the stages, however, the survival rates show a wide range of variations, and overlap with adjacent stages.

Bottom Line: Multivariate analysis identified tumor length, surgical approach, number of examined lymph node, number of positive lymph node, extent of positive lymph node, grade, and depth of invasion as independent risk factors for survival.The discriminative ability of the nomogram was externally determined using the validation cohort, showing that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.715, 95% CI 0.671-0.759).The C-index of the nomogram was significantly higher than that of the sixth edition (0.664, P-value < 0.0001) and the seventh edition (0.696, P-value < 0.0003) of the TNM classification.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Institute, Zhejiang Cancer Hospital & Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology of Zhejiang Province, Hangzhou, China.

ABSTRACT
Nomogram has demonstrated its capability in individualized estimates of survival in diverse cancers. Here we retrospectively investigated 1195 patients with esophageal squamous-cell carcinoma (ESCC) who underwent radical esophagectomy at Zhejiang Cancer Hospital in Hangzhou, China. We randomly assigned two-thirds of the patients to a training cohort (n = 797) and one-third to a validation cohort (n = 398). Cox proportional hazards regression analyses were performed using the training cohort, and a nomogram was developed for predicting 3-year and 5-year overall survival rates. Multivariate analysis identified tumor length, surgical approach, number of examined lymph node, number of positive lymph node, extent of positive lymph node, grade, and depth of invasion as independent risk factors for survival. The discriminative ability of the nomogram was externally determined using the validation cohort, showing that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.715, 95% CI 0.671-0.759). The C-index of the nomogram was significantly higher than that of the sixth edition (0.664, P-value < 0.0001) and the seventh edition (0.696, P-value < 0.0003) of the TNM classification. This study developed the first nomogram for ESCC, which can be applied in daily clinical practice for individualized survival prediction.

No MeSH data available.


Related in: MedlinePlus