Nomogram to Predict Overall Survival for Thoracic Esophageal Squamous Cell Carcinoma with Radical Surgery Alone

ZHANG Huan; YANG Mingwei; KANG Mei; ZHU Liyang; WANG Yichun

doi:10.15926/j.cnki.issn2096-7381.2024.02.002

Abstract：Objective We aimed to develop and validate a nomogram to predict the overall survival(OS)in TESCCs with radical surgery alone for screening the high-risk populations and guiding their rea-sonable adjuvant therapies.Methods TESCCs with pathological pTl-4aN0-3M0 undergoing radical surgery without perioperative therapies from Jan 2010 to June 2017 in our hospital were enrolled in the train-ing cohort and TESCCs in the Surveillance,Epidemiology,and End Results(SEER)(2004-2015)dataset were enrolled in the validation cohort.The nomogram was developed using independent prognosis for OS ana-lyzed by the Cox proportional hazard regression in the training cohort and subjected to the validation cohort.The predictive accuracy and discriminative ability of the nomogram was evaluated by the area under the curve(AUC)of the receiver operating characteristic curves,calibration curves.Results A total number of 706 patients(420 patients in the training cohort and 286 patients in the validation cohort)were enrolled in this study.The Cox regression analysis indicated that the pathological T stage,N stage,gender and tumor length were independent prognosis for OS.The nomogram constructed by these variables showed that the AUC for predicting 5-year OS in the training and validation cohorts were 0.711 and 0.740 respectively,which were higher than that of the 8th AJCC TNM stage systems.Calibration curves indicated good consistency between the nomogram prediction and actual observation for OS.Risk group stratification based on the nomogram scores allowed better distinction between survival curves than 8th AJCC TNM stage systems.Conclusion We have successfully established a novel nomogram with good risk stratification and discriminative ability for predicting OS in TESCCs with radical surgery alone.