J Cancer 2017; 8(18):3755-3763. doi:10.7150/jca.20828

Research Paper

A nomogram based on phosphorylated AKT1 for predicting locoregional recurrence in patients with oesophageal squamous cell carcinoma

Weiwei Yu1,2*, Li Chu1,5*, Kuaile Zhao1,5, Haiquan Chen3,5, Jiaqing Xiang3,5, Yawei Zhang3,5, Hecheng Li3,5, Weixin Zhao1,5, Menghong Sun4,5, Qiao Wei4,5, Xiaolong Fu1,6, Congying Xie7, Zhengfei Zhu1,5✉

1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China;
2. Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China;
3. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China;
4. Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China;
5. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;
6. Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China;
7. Radiotherapy and Chemotherapy Department, the 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
*Weiwei Yu and Li Chu contributed equally to this work.

Abstract

Background: The AKT signalling pathway controls survival and growth in many malignant tumours. However, the prognostic value of phosphorylated AKT1 (p-AKT1) for locoregional-progression free survival (LPFS) in oesophageal squamous cell carcinoma (ESCC) has not been established. Our aim was to develop a nomogram to predict local recurrence using p-AKT1 and main clinical characteristics in patients with thoracic ESCC undergoing radical three-field lymph node dissection.

Methods: Immunohistochemistry was performed to examine p-AKT1 expression in 181 thoracic ESCC patients. The Kaplan-Meier method was used to calculate LPFS. Cox regression analysis was also performed to evaluate prognostic factors. A nomogram comprising biological and clinical factors was established to predict LPFS.

Results: The 5-year LPFS rate was 63.9%. Multivariate analysis revealed that expression of p-AKT1 (p<0.001), pathologic N category (p=0.004) and number of lymph nodes retrieved (p=0.001) were independent prognostic factors for LPFS. Increased expression of p-AKT1 was associated with decreased LPFS in patients with ESCC. In addition, a nomogram was established based on all significant independent factors for locoregional recurrence risk. Harrell's c-index for predicting LPFS was 0.78.

Conclusion: Activation of AKT1 was associated with poor locoregional control in ESCC patients. The nomogram, based on p-AKT1 expression and clinically significant parameters, could be used as an accurate stratification model for predicting locoregional recurrence in patients with ESCC after radical resection.

Keywords: Esophageal squamous cell carcinoma, Locoregional-progression free survival, Phosphorylated AKT1, Nomogram, Prognostic factor

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How to cite this article:
Yu W, Chu L, Zhao K, Chen H, Xiang J, Zhang Y, Li H, Zhao W, Sun M, Wei Q, Fu X, Xie C, Zhu Z. A nomogram based on phosphorylated AKT1 for predicting locoregional recurrence in patients with oesophageal squamous cell carcinoma. J Cancer 2017; 8(18):3755-3763. doi:10.7150/jca.20828. Available from http://www.jcancer.org/v08p3755.htm