J Cancer 2020; 11(14):4023-4029. doi:10.7150/jca.40767

Research Paper

Development and Validation of an Individualized Nomogram for Predicting Survival in Patients with Esophageal Carcinoma after Resection

Feng Du1, Zhiwei Sun1, Jun Jia1, Ying Yang1, Jing Yu1, Youwu Shi1, Bo Jia2, Jiuda Zhao3, Xiaodong Zhang1✉

1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), The VIPII Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, Beijing, China
2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education /Beijing), Department of Thoracic Medical oncology, Peking University Cancer Hospital and Institute, Beijing, China
3. Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining, China

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Citation:
Du F, Sun Z, Jia J, Yang Y, Yu J, Shi Y, Jia B, Zhao J, Zhang X. Development and Validation of an Individualized Nomogram for Predicting Survival in Patients with Esophageal Carcinoma after Resection. J Cancer 2020; 11(14):4023-4029. doi:10.7150/jca.40767. Available from http://www.jcancer.org/v11p4023.htm

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Abstract

An accurate estimation of prognosis of the esophageal carcinoma patients after surgery is urgently needed. Clinical nomogram has been developed to quantify risk by incorporating prognostic factors for individual patient. Based on the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2013, a total of 4566 patients were selected. Of those, 3198 patients were assigned to training set to construct the nomogram, which incorporated age, gender, histology, grade, T stage, N stage, nodes examined, radiation and chemotherapy. The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. The C-index of the nomogram was 0.71(95%CI 0.70-0.72), which was statistically higher than the TNM staging system. The results were then validated using bootstrap resampling and a validation set of 1368 patients in the SEER database. Besides, in the esophageal squamous cell carcinoma and esophageal adenocarcinoma subgroups, the nomogram discrimination was superior to the TNM staging system. It is likely that these results would play a supplementary role in the current staging system and help to identify the high risk population after surgery.

Keywords: Esophageal Neoplasms, Nomogram, Prognosis