Public Health Open Access (PHOA)
ISSN: 2578-5001
Research Article
Survival Prediction Model for Esophageal Squamous Cell
Carcinoma Patients with Lymph Node Metastasis who had
Surgery: Based on SEER Database
Abstract
Objective: To establish a nomogram model for predicting the overall survival (OS) of esophageal squamous cell carcinoma (ESCC) patients with lymph nodes metastasis (LNM) who had surgery.
Methods: ESCC patients with LNM who received surgery from 2004 to 2015 in the Surveillance, Epidemiology, and Final Results (SEER) database were selected. The whole cohort (n=468) was randomly divided into training (n=328) and validation group(n=140). The Cox regression models were applied to identify the related prognostic factors for the nomogram. The performance of the nomogram was evaluated by Harrell’s concordance index (C-index), the area under the time-dependent receiver operating characteristics curve (AUC), the net reclassification improvement (NRI), integrated discrimination improvement (IDI), decision curve analysis (DCA), and calibration curve.
Results: Surgery prime site, T status, M status, radiation sequence with surgery, age, race, and gender were incorporated in the nomogram. The better discrimination performance, more accurate prediction, and superior clinical usage of nomogram can be observed according to C-index, AUC, NRI, IDI, and DCA when compared to the traditional staging system in both cohorts. The excellent consistency was shown from calibration plots in 2 cohorts.
Conclusion: The nomogram was developed and validated to predict OS for targeted ESCC patients.
Keywords: Esophageal Squamous Cell Carcinoma; Lymphatic Metastasis; Surgery; Radiation
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