Cancer Management and Research (Oct 2021)
A Survival Prediction Nomogram for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery
Abstract
Tianyan Ding1,2 *, Cantong Liu1,2 *, Binliang Huang,1,2 Lingyu Chu,1,2 Laifeng Wei,1,2 Yiwei Lin,1,2 Yun Luo,1,2 Biao Zhang,1,2 Chaoqun Hong,3 Yiwei Xu,1,2 Yuhui Peng1,2 1Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, People’s Republic of China; 2Precision Medicine Research Center, Shantou University Medical College, Shantou, People’s Republic of China; 3Guangdong Provincial Key Laboratory of Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yiwei XuDepartment of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, 515041, Guangdong, People’s Republic of ChinaFax +86-754-8856-0352Email [email protected] Peng Email [email protected]: Neoadjuvant chemoradiotherapy (NCRT) followed by surgery is a component of the standard treatment for resectable locally advanced esophageal squamous cell carcinoma (ESCC), and the parameters for survival prediction are not clear yet. Our study aimed to construct a survival prediction nomogram for ESCC with NCRT followed by surgery.Methods: We analyzed hematological parameters and related-derivative indexes from 122 ESCC patients treated with NCRT followed by surgery. Univariate and multivariate Cox survival analyses were performed to identify independent prognostic factors to establish a nomogram and predict overall survival (OS). The predictive value of the nomogram for OS was evaluated by the concordance index (C-index), decision curve analysis (DCA), the clinical impact curve (CIC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).Results: The pretreatment nutritional candidate, prognostic nutrition index, inflammation-related absolute monocyte count and TNM staging were entered into the nomogram for ESCC with NCRT followed by surgery. The C-index of the nomogram for OS was 0.790 (95% CI = 0.688– 0.893), which was higher than that of TNM staging (0.681; 95% CI = 0.565– 0.798, P = 0.026). The DCA, CIC, NRI, and IDI of the nomogram showed moderate improvement in predicting survival. Based on the cut point calculated according to the constructed nomogram, the high-risk group had poorer OS than that of the low-risk group (P < 0.05).Conclusion: A novel nomogram based on nutrition- and inflammation-related indicators might help predict the survival of ESCC treated with NCRT followed by surgery.Keywords: esophageal squamous cell carcinoma, neoadjuvant chemoradiotherapy, surgery, nomogram, survival, prognosis
