Development of a prognostic nomogram and risk stratification system for elderly patients with esophageal squamous cell carcinoma undergoing definitive radiotherapy: a multicenter retrospective analysis (3JECROG R-03 A)
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View abstract on PubMed
Summary
This summary is machine-generated.This study developed a nomogram to predict survival for elderly esophageal squamous cell carcinoma patients undergoing radiotherapy. The nomogram improves risk stratification and personalized treatment planning compared to current staging systems.
Area Of Science
- Oncology
- Radiotherapy
- Medical Statistics
Background
- Elderly patients with esophageal squamous cell carcinoma (ESCC) require tailored treatment strategies.
- Definitive radiotherapy (RT) and concurrent chemoradiotherapy (CRT) are common treatments for ESCC.
- Accurate prediction of overall survival (OS) is crucial for personalized treatment planning.
Purpose Of The Study
- To develop and validate a nomogram model for predicting OS in elderly ESCC patients treated with RT or CRT.
- To establish a risk stratification system for improved clinical decision-making.
- To compare the predictive performance of the nomogram against the AJCC staging system.
Main Methods
- Retrospective analysis of 718 elderly ESCC patients from 10 medical centers (2004-2016).
- Identification of independent prognostic factors using univariate and multifactorial Cox regression.
- Construction and validation of a nomogram using concordance statistics (C-index), AUC, NRI, and IDI.
- Comparison with AJCC staging and assessment of clinical utility via decision curve analysis (DCA).
Main Results
- Key independent prognostic factors for OS included diabetes, tumor volume, tumor length, location, clinical stage (TNM), and RT response.
- The developed nomogram demonstrated superior prediction accuracy and discrimination compared to AJCC staging (C-index 0.597 vs. 0.562).
- Nomogram-based risk stratification revealed distinct 5-year OS rates for low, intermediate, and high-risk groups.
Conclusions
- The study successfully identified significant prognostic factors for elderly ESCC patients receiving RT/CRT.
- The developed nomogram offers enhanced prediction performance, discrimination, and clinical utility over AJCC staging.
- This nomogram facilitates more accurate survival predictions and personalized risk management for ESCC patients.
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