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Prognostic prediction model for patients with pathological T1N0 stage esophageal squamous cell carcinoma undergone esophagectomy

  • 0Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, China.
Journal of Thoracic Disease +

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September 13, 2024

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September 13, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

This study developed a nomogram to predict survival in early esophageal squamous cell carcinoma (ESCC) patients without lymph node metastasis (LNM). The model identified surgical approach, T1 substage, and CEA levels as key prognostic factors for improved patient outcomes.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Cancer Prognostics

Background

  • Early esophageal squamous cell carcinoma (ESCC) lacks reliable prognostic models for patients without lymph node metastasis (LNM).
  • Accurate prognostication is crucial for guiding treatment decisions in T1N0 ESCC.
  • Predictive tools are needed to stratify risk and inform management strategies.

Purpose Of The Study

  • To develop and validate a predictive nomogram for overall survival (OS) in T1N0 ESCC patients.
  • To identify independent prognostic factors for survival in this patient cohort.
  • To provide a tool for individualized risk assessment and survival prediction.

Main Methods

  • Retrospective review of 275 T1N0 ESCC patients from three institutes (2014-2021).
  • Prognostic factor evaluation using Cox proportional hazards model and nomogram development.
  • Survival analysis via Kaplan-Meier method and log-rank test; external validation performed.

Main Results

  • Multivariable analysis identified surgical approach, T1 substage, and carcinoembryonic antigen (CEA) level as independent prognostic factors.
  • The nomogram demonstrated good predictive performance (AUCs for 1-, 3-, 5-year OS: 0.783, 0.711, 0.612).
  • A nomogram-derived risk stratification identified high-risk and low-risk groups with significantly different OS (P<0.001).

Conclusions

  • Left surgical approach, T1b substage, and elevated CEA are associated with poorer prognosis in T1N0 ESCC.
  • The developed nomogram effectively predicts individual survival outcomes for T1N0 ESCC patients.
  • This tool aids in personalized risk assessment and clinical decision-making for early-stage ESCC.

Keywords:

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