Prognostic prediction and comparison of three staging programs for patients with advanced (T2-T4) esophageal squamous carcinoma after radical resection
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View abstract on PubMed
Summary
This summary is machine-generated.Log odds of positive lymph nodes (LODDS) is a superior prognostic indicator for advanced esophageal squamous cell carcinoma compared to N stage and lymph node rate. This new model aids in treatment recommendations post-surgery.
Area Of Science
- Oncology
- Surgical Oncology
- Cancer Prognostics
Background
- Lymph node staging is crucial for esophageal cancer prognosis but accuracy is debated.
- Existing systems like N stage, lymph node rate (LNR), and log odds of positive lymph nodes (LODDS) require further validation for advanced esophageal squamous cell carcinoma (ESCC).
Purpose Of The Study
- To evaluate and compare the prognostic significance of N stage, LNR, and LODDS in patients with advanced ESCC (T2-T4).
- To identify the most accurate lymph node staging system for predicting overall survival (OS) in advanced ESCC.
Main Methods
- A cohort of 319 patients with advanced ESCC was analyzed, with validation using 409 patients from the SEER database.
- Multivariate Cox regression was used to build prognostic models and assess independent risk factors.
- Model accuracy was compared using metrics like C-index, -2LLR, LRχ2, and AIC. A nomogram was developed for the best-performing model.
Main Results
- All three systems (N stage, LNR, LODDS) were identified as independent prognostic factors for advanced ESCC.
- LODDS demonstrated superior predictive accuracy, evidenced by higher C-index and LRχ2 values, and lower AIC and -2LLR compared to N stage and LNR.
- A LODDS-based nomogram showed strong calibration and promising clinical applicability via ROC curves and DCA.
Conclusions
- Log odds of positive lymph nodes (LODDS) is a highly promising prognostic indicator for advanced ESCC.
- The developed LODDS-based nomogram can potentially guide treatment recommendations and improve patient management after surgery.
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