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Nomograms for predicting overall and recurrence‐free survival after trimodality therapy for esophageal adenocarcinoma
Author(s) -
Merritt Robert E.,
AbdelRasoul Mahmoud,
Souza Desmond M. D',
Kneuertz Peter J.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26349
Subject(s) - nomogram , medicine , esophagectomy , proportional hazards model , stage (stratigraphy) , multivariate analysis , oncology , adjuvant therapy , adenocarcinoma , esophageal adenocarcinoma , t stage , concordance , survival analysis , neoadjuvant therapy , esophageal cancer , chemotherapy , overall survival , cancer , paleontology , breast cancer , biology
Background Locally advanced esophageal carcinoma is treated with neoadjuvant chemoradiation and esophagectomy. Patients may still experience recurrence and death despite undergoing potentially curative trimodality therapy. This study describes predictive nomograms for recurrence‐free (RFS) and overall survival (OS) after the completion of trimodality therapy. Methods A total of 215 patients with esophageal adenocarcinoma underwent trimodality therapy from September 2010 to April 2018. Multivariate Cox proportional hazards regression models were used to create nomograms for OS and RFS. Kaplan–Meier survival curves were calculated for OS and RFS comparing high‐risk and low‐risk cohorts. Results On multivariate analysis, clinical N‐stage, tumor differentiation, tumor regression grade, anastomotic leak, body mass index, age, and number of lymph nodes removed were predictive variables for overall survival. Clinical N‐stage, tumor differentiation, tumor regression grade, anastomotic leak, age, and positive lymph nodes were significant predictors of RFS in a multivariate model. The nomogram for OS had good predictive ability (Harrell's Concordance index [C‐index]: 0.71 [95% confidence interval {CI}: 0.66–0.76]). The nomogram for RFS also performed well (C‐index: 0.70 [95% CI: 0.65–0.74]). Conclusion Our nomograms can accurately predict OS and RFS after trimodality therapy and may provide guidance regarding adjuvant therapy and surveillance.