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Updated: Jan 12, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Development and validation of a nomogram for predicting long-term survival in pN + esophageal squamous cell carcinoma
Changsen Leng1,2,3, Yingying Cui1,4, Hong Yang1,2,3
1State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
Background:
The pN + status represents a crucial risk factor for esophageal squamous cell carcinoma (ESCC) patients without neoadjuvant therapy after radical resection. The necessity for adjuvant therapy post-surgery remains debatable. Our goal was to develop a personalized nomogram for predicting overall survival (OS) in pN + ESCC patients.
Materials And Methods:
This study included 705 ESCC patients spanning from 1997 to 2016. All patients were staged according to the AJCC 8th edition TNM staging system and underwent radical resection without neoadjuvant therapy. The nomogram was constructed through univariate, multivariate, and LASSO Cox regression analyses. Its performance was evaluated and compared with the TNM staging system.
Results:
The training and external validation cohorts included 451 and 254 patients, respectively. Independent prognostic factors included age, history of drinking, thoracic duct ligation, pT stage, pN stage, length of ICU stay, and postoperative adjuvant chemotherapy. The AUC values of nomogram at 2- and 5-year intervals in the training cohort were 0.732 and 0.716, respectively, and 0.697 and 0.705 in the external validation cohort, respectively, both superior to the TNM staging system. The nomogram's effectiveness and stability were validated internally and externally, with significant OS differences observed among the various risk groups defined by the nomogram.
Conclusions:
This study developed a prognostic nomogram for pN + ESCC patients who have not undergone neoadjuvant therapy and have undergone radical resection, providing superior predictive accuracy compared to the TNM staging system and easy to use in routine practice.
