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Published in: Journal of Cardiothoracic Surgery 1/2023

Open Access 01-12-2023 | Esophageal Cancer | Research article

Establishment and validation of a prognostic risk classification for patients with stage T1-3N0M0 esophageal squamous cell carcinoma

Authors: Yang-Yu Huang, Yan Zheng, Shen-Hua Liang, Lei-Lei Wu, Xuan Liu, Wen-Qun Xing, Guo-Wei Ma

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

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Abstract

Introduction

At present, clinical factors and hematological indicators have been proved to have great potential in predicting the prognosis of cancer patients, and no one has combined these two valuable indicators to establish a prognostic model for esophageal squamous cell carcinoma (ESCC) patients with stage T1-3N0M0 after R0 resection. To verify, we aimed to combine these potential indicators to establish a prognostic model.

Methods

Stage T1-3N0M0 ESCC patients from two cancer centers (including training cohort: N = 819, and an external validation cohort: N = 177)—who had undergone esophagectomy in 1995–2015 were included. We integrated significant risk factors for death events by multivariable logistic regression methods and applied them to the training cohort to build Esorisk. The parsimonious aggregate Esorisk score was calculated for each patient; the training set was divided into three prognostic risk classes according to the 33rd and 66th percentiles of the Esorisk score. The association of Esorisk with cancer-specific survival (CSS) was assessed using Cox regression analyses.

Results

The Esorisk model was: [10 + 0.023 × age + 0.517 × drinking history − 0.012 × hemoglobin–0.042 × albumin − 0.032 × lymph nodes]. Patients were grouped into three classes—Class A (5.14–7.26, low risk), Class B (7.27–7.70, middle risk), and Class C (7.71–9.29, high risk). In the training group, five-year CSS decreased across the categories (A: 63%; B: 52%; C: 30%, Log-rank P < 0.001). Similar findings were observed in the validation group. Additionally, Cox regression analysis showed that Esorisk aggregate score remained significantly associated with CSS in the training cohort and validation cohort after adjusting for other confounders.

Conclusions

We combined the data of two large clinical centers, and comprehensively considered their valuable clinical factors and hematological indicators, established and verified a new prognostic risk classification that can predict CSS of stage T1-3N0M0 ESCC patients.
Literature
28.
go back to reference Yang H, Liu H, Chen Y, et al; AME Thoracic Surgery Collaborative Group. Neoadjuvant chemoradiotherapy followed by surgeryversus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): a phase III multicenter, randomized, open-label clinical trial. J Clin Oncol. 2018;36:2796–2803. https://doi.org/10.1200/JCO.2018.79.1483. Yang H, Liu H, Chen Y, et al; AME Thoracic Surgery Collaborative Group. Neoadjuvant chemoradiotherapy followed by surgeryversus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): a phase III multicenter, randomized, open-label clinical trial. J Clin Oncol. 2018;36:2796–2803. https://​doi.​org/​10.​1200/​JCO.​2018.​79.​1483.
Metadata
Title
Establishment and validation of a prognostic risk classification for patients with stage T1-3N0M0 esophageal squamous cell carcinoma
Authors
Yang-Yu Huang
Yan Zheng
Shen-Hua Liang
Lei-Lei Wu
Xuan Liu
Wen-Qun Xing
Guo-Wei Ma
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-023-02294-2

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