食管癌肺转移的有效预后模型:列线图
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摘要
目的利用临床病理因素建立模型来预测食管癌肺转移患者的预后情况。方法收集美国国家癌症研究所监测、流行病学和最终结果 (SEER)数据库中2010—2015年194例食管癌肺转移患者的信息。通过X-tile软件确定年龄的最佳截断值。通过SPSS(v25.0)用log-rank方法和Cox比例风险模型分析预后因素。单因素分析有意义的变量通过R studio软件(版本号3.5.1)构建预测列线图。结果 194例食管癌肺转移患者中位生存时间为7.0个月,3个月生存率为69.9%,1年生存率为27.7%。年龄(HR=1.51,95%CI:1.066～2.140)、病理类型(HR=0.736,95%CI:0.543～0.998)为食管癌肺转移患者预后的独立影响因素。列线图C-index值为0.634(95%CI:0.585～0.683)。结论对于食管癌肺转移患者,年轻、病理类型为腺癌与更好的预后相关。列线图的预测效果良好。
Objective To establish a prediction model for the prognosis of patients with esophageal cancer lung metastasis.Methods Data from 194 patients with esophageal cancer lung metastasis from 2010 to 2015 was collected from the National Cancer Institute Surveillance, Epidemiology and End Results(SEER) database. The best cutoff value for age was determined by X-tile software.Prognostic factors were analyzed by SPSS(v25.0) with the log-rank method and the Cox proportional hazard model. Risk factors from univariate analysis were used to construct prediction nomogram with R studio software(version 3.5.1). Results The median survival time of 194 patients with esophageal cancer lung metastasis was 7.0 months, the 3-month survival rate was 69.9%, and the 1-year survival rate was 27.7%. Age(HR=1.51, 95% CI: 1.066-2.140) and pathological type(HR=0.736, 95% CI: 0.543-0.998) were independent prognostic factors for patients with esophageal cancer lung metastasis. The value of C-index was 0.634(95% CI=0.585-0.683). Conclusion For patients with esophageal cancer lung metastasis, being young and adenocarcinoma are associated with a better prognosis. The prediction of the nomogram is good.
Objective To establish a prediction model for the prognosis of patients with esophageal cancer lung metastasis.Methods Data from 194 patients with esophageal cancer lung metastasis from 2010 to 2015 was collected from the National Cancer Institute Surveillance, Epidemiology and End Results(SEER) database. The best cutoff value for age was determined by X-tile software.Prognostic factors were analyzed by SPSS(v25.0) with the log-rank method and the Cox proportional hazard model. Risk factors from univariate analysis were used to construct prediction nomogram with R studio software(version 3.5.1). Results The median survival time of 194 patients with esophageal cancer lung metastasis was 7.0 months, the 3-month survival rate was 69.9%, and the 1-year survival rate was 27.7%. Age(HR=1.51, 95% CI: 1.066-2.140) and pathological type(HR=0.736, 95% CI: 0.543-0.998) were independent prognostic factors for patients with esophageal cancer lung metastasis. The value of C-index was 0.634(95% CI=0.585-0.683). Conclusion For patients with esophageal cancer lung metastasis, being young and adenocarcinoma are associated with a better prognosis. The prediction of the nomogram is good.
引文
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[14]Zhang WY,Chen XX,Chen WH,et al.Nomograms for predicting risk of locoregional recurrence and distant metastases for esophageal cancer patients after radical esophagectomy[J].BMC Cancer,2018,18(1):879.
[15]Goense L,Van Rossum PSN,Xi M,et al.Preoperative nomogram to risk stratify patients for the benefit of trimodality therapy in esophageal adenocarcinoma[J].Ann Surg Oncol,2018,25(6):1598-1607.
[2]左婷婷.中国食管癌发病状况与趋势分析[J].中华肿瘤杂志2016,38(9):703-708.
[3]Fujinaka Y,Morita M,Ohga T,et al.Definitive chemoradiotherapy and salvage esophagectomy for esophageal cancer associated with multiple lung metastases:a case report[J].Int Surg,2014,99(5):640-644.
[4]Kim E,Koroukian S,Thomas CR.Conditional survival of esophageal cancer:an analysis from the SEER Registry(1988-2011)[J].J Thorac Oncol,2015,10(10):1490-1497.
[5]Njei B,Mccarty TR,Birk JW.Trends in esophageal cancer survival in United States adults from 1973 to 2009:A SEER database analysis[J].JGastroenterol Hepatol,2016,31(6):1141-1146.
[6]郑炎标.晚期食管癌患者预后影响因素分析[J].深圳中西医结合杂志,2018,28(15):175-176.
[7]刘爱娜.138例晚期食管癌的化疗疗效和预后因素分析[J].癌症,2008,27(4):400-406.
[8]Abrams JA,Lee PC,Port JL,et al.Cigarette smoking and risk of lung metastasis from esophageal cancer[J].Cancer Epidemiol Biomarkers Prev,2008,17(10):2707-2713.
[9]Kato H,Sato A,Fukuda H,et al.A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma:Japan Clinical Oncology Group study(JCOG9708)[J].Jpn J Clin Oncol,2009,39(10):638-643.
[10]Kozu Y,Sato H,Tsubosa Y,et al.Surgical treatment for pulmonary metastases from esophageal carcinoma after definitive chemoradiotherapy:experience from a single institution[J].JCardiothorac Surg,2011,6:135.
[11]Grivas N,Wit E,Tillier C,et al.Validation and head-to-head comparison of three nomograms predicting probability of lymph node invasion of prostate cancer in patients undergoing extended and/or sentinel lymph node dissection[J].Eur J Nucl Med Mol Imaging,2017,44(13):2213-2226.
[12]姚儒.乳腺癌列线图模型的研究进展[J].中国癌症杂志,2013,23(9):765-771.
[13]Eil R,Diggs BS,Wang SJ,et al.Nomogram for predicting the benefit of neoadjuvant chemoradiotherapy for patients with esophageal cancer:a SEER-Medicare analysis[J].Cancer,2014,120(4):492-498.
[14]Zhang WY,Chen XX,Chen WH,et al.Nomograms for predicting risk of locoregional recurrence and distant metastases for esophageal cancer patients after radical esophagectomy[J].BMC Cancer,2018,18(1):879.
[15]Goense L,Van Rossum PSN,Xi M,et al.Preoperative nomogram to risk stratify patients for the benefit of trimodality therapy in esophageal adenocarcinoma[J].Ann Surg Oncol,2018,25(6):1598-1607.