J Cancer 2017; 8(18):3755-3763. doi:10.7150/jca.20828
A nomogram based on phosphorylated AKT1 for predicting locoregional recurrence in patients with oesophageal squamous cell carcinoma
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.
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
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