预后预测和对三个分期方案的比较,用于患有晚期 (T2-T4) 食道状癌症的患者,后从根本切除
Zhongshuai Wang1,2, Feng Li1,2, Mingchuang Zhu1,2
1Cancer Hospital Affiliated to Shanxi Medical University/ Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan, China.
Frontiers in oncology
|July 12, 2024
概括
阳性淋巴结的日志概率 (LODDS) 是晚期食道状细胞癌的优越预后指标,与N阶段和淋巴结率相比. 这种新模型有助于在手术后提出治疗建议.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症预后 癌症预后
背景情况:
- 淋巴结分期对食道癌的预后至关重要,但准确性仍有争议.
- 现有的系统如N阶段,淋巴结率 (LNR) 和阳性淋巴结的日志几率 (LODDS) 需要进一步验证晚期食道状细胞癌 (ESCC).
研究的目的:
- 评估和比较N阶段,LNR和LODDS在晚期ESCC (T2-T4) 患者的预后意义.
- 确定最准确的淋巴结分期系统,用于预测晚期ESCC的整体存活率 (OS).
主要方法:
- 分析了319名晚期ESCC患者的队列,并使用SEER数据库中的409名患者进行了验证.
- 使用多变量考克斯回归来构建预后模型并评估独立的风险因素.
- 使用C指数,-2LLR,LRχ2和AIC等指标进行模型准确性比较. 为表现最好的模型开发了一个名字图.
主要成果:
- 所有三个系统 (N阶段,LNR,LODDS) 都被确定为高级ESCC的独立预后因素.
- 与N阶段和LNR相比,LODDS显示出更高的C指数和LRχ2值,以及较低的AIC和-2LLR.
- 一个基于LODDS的名图显示出强大的校准和通过ROC曲线和DCA的有前途的临床适用性.
结论:
- 阳性淋巴结的日志概率 (LODDS) 是高级ESCC的非常有前途的预后指标.
- 开发的基于LODDS的名图可能会指导治疗建议,并改善手术后的患者管理.
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