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Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study

BACKGROUND: Multimodal therapies based on surgical resection have been recommended for the treatment of adenocarcinoma of the oesophagogastric junction (AEG). We aimed to evaluate prognostic factors in AEG patients receiving neoadjuvant chemoradiotherapy and to build predictive models. METHODS: T3 −...

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Autores principales: Du, Rongxu, Ming, Jiao, Geng, Jianhao, Zhu, Xianggao, Zhang, Yangzi, Li, Shuai, Liu, Zhiyan, Wang, Hongzhi, Wang, Zhilong, Tang, Lei, Zhang, Xiaotian, Wu, Aiwen, Bu, Zhaode, Yan, Yan, Li, Zhongwu, Li, Yongheng, Li, Ziyu, Wang, Weihu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8896317/
https://www.ncbi.nlm.nih.gov/pubmed/35241109
http://dx.doi.org/10.1186/s13014-022-02016-3
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author Du, Rongxu
Ming, Jiao
Geng, Jianhao
Zhu, Xianggao
Zhang, Yangzi
Li, Shuai
Liu, Zhiyan
Wang, Hongzhi
Wang, Zhilong
Tang, Lei
Zhang, Xiaotian
Wu, Aiwen
Bu, Zhaode
Yan, Yan
Li, Zhongwu
Li, Yongheng
Li, Ziyu
Wang, Weihu
author_facet Du, Rongxu
Ming, Jiao
Geng, Jianhao
Zhu, Xianggao
Zhang, Yangzi
Li, Shuai
Liu, Zhiyan
Wang, Hongzhi
Wang, Zhilong
Tang, Lei
Zhang, Xiaotian
Wu, Aiwen
Bu, Zhaode
Yan, Yan
Li, Zhongwu
Li, Yongheng
Li, Ziyu
Wang, Weihu
author_sort Du, Rongxu
collection PubMed
description BACKGROUND: Multimodal therapies based on surgical resection have been recommended for the treatment of adenocarcinoma of the oesophagogastric junction (AEG). We aimed to evaluate prognostic factors in AEG patients receiving neoadjuvant chemoradiotherapy and to build predictive models. METHODS: T3 − T4N + M0 AEG patients with resectable Siewert type II/III tumours were enrolled in this study. All patients underwent neoadjuvant chemoradiation, followed by radical surgery or systemic therapy according to clinical response. Survival analysis was performed using the Kaplan–Meier method; multivariate analysis using the Cox proportional hazards method was also conducted. The Harrell concordance index (C-index) was used to test the prognostic value of models involving prognostic factors, and consistency between actual and predicted survival rates was evaluated by calibration curves. RESULTS: From February 2009 to February 2018, 79 patients were treated with neoadjuvant chemoradiotherapy; 60 patients of them underwent radical surgery. The R0 resection rate was 98.3%, and 46.7% of patients achieved a major pathologic response (MPR), namely, a residual tumour issue less than 10%. The 5-year overall survival (OS) rate was 63%, and the 5-year progression-free survival (PFS) rate was 48%. The incidence of grade 3 complications was 21.5%, and no grade 4 complications were reported. According to the results of univariate and multivariate analyses, we included the neutrophil–lymphocyte ratio (NLR), prognostic nutrition index (PNI), eosinophilic granulocyte (EOS) and postoperative pathologic stage in nomogram analysis to establish prediction models for OS and PFS; the C-index of each model was 0.814 and 0.722, respectively. Both the C-index and calibration curves generated to validate consistency between the actual and predicted survival indicated that the models were well calibrated and of good predictive value. CONCLUSIONS: AEG patients achieved favourable downstaging and pathologic response after neoadjuvant chemoradiation, with acceptable adverse effects. Inflammation-based and nutrition-related factors and postoperative pathologic stage had a significant influence on OS and PFS, and the predictive value was verified through prognostic models.
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spelling pubmed-88963172022-03-14 Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study Du, Rongxu Ming, Jiao Geng, Jianhao Zhu, Xianggao Zhang, Yangzi Li, Shuai Liu, Zhiyan Wang, Hongzhi Wang, Zhilong Tang, Lei Zhang, Xiaotian Wu, Aiwen Bu, Zhaode Yan, Yan Li, Zhongwu Li, Yongheng Li, Ziyu Wang, Weihu Radiat Oncol Research BACKGROUND: Multimodal therapies based on surgical resection have been recommended for the treatment of adenocarcinoma of the oesophagogastric junction (AEG). We aimed to evaluate prognostic factors in AEG patients receiving neoadjuvant chemoradiotherapy and to build predictive models. METHODS: T3 − T4N + M0 AEG patients with resectable Siewert type II/III tumours were enrolled in this study. All patients underwent neoadjuvant chemoradiation, followed by radical surgery or systemic therapy according to clinical response. Survival analysis was performed using the Kaplan–Meier method; multivariate analysis using the Cox proportional hazards method was also conducted. The Harrell concordance index (C-index) was used to test the prognostic value of models involving prognostic factors, and consistency between actual and predicted survival rates was evaluated by calibration curves. RESULTS: From February 2009 to February 2018, 79 patients were treated with neoadjuvant chemoradiotherapy; 60 patients of them underwent radical surgery. The R0 resection rate was 98.3%, and 46.7% of patients achieved a major pathologic response (MPR), namely, a residual tumour issue less than 10%. The 5-year overall survival (OS) rate was 63%, and the 5-year progression-free survival (PFS) rate was 48%. The incidence of grade 3 complications was 21.5%, and no grade 4 complications were reported. According to the results of univariate and multivariate analyses, we included the neutrophil–lymphocyte ratio (NLR), prognostic nutrition index (PNI), eosinophilic granulocyte (EOS) and postoperative pathologic stage in nomogram analysis to establish prediction models for OS and PFS; the C-index of each model was 0.814 and 0.722, respectively. Both the C-index and calibration curves generated to validate consistency between the actual and predicted survival indicated that the models were well calibrated and of good predictive value. CONCLUSIONS: AEG patients achieved favourable downstaging and pathologic response after neoadjuvant chemoradiation, with acceptable adverse effects. Inflammation-based and nutrition-related factors and postoperative pathologic stage had a significant influence on OS and PFS, and the predictive value was verified through prognostic models. BioMed Central 2022-03-03 /pmc/articles/PMC8896317/ /pubmed/35241109 http://dx.doi.org/10.1186/s13014-022-02016-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Du, Rongxu
Ming, Jiao
Geng, Jianhao
Zhu, Xianggao
Zhang, Yangzi
Li, Shuai
Liu, Zhiyan
Wang, Hongzhi
Wang, Zhilong
Tang, Lei
Zhang, Xiaotian
Wu, Aiwen
Bu, Zhaode
Yan, Yan
Li, Zhongwu
Li, Yongheng
Li, Ziyu
Wang, Weihu
Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title_full Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title_fullStr Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title_full_unstemmed Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title_short Establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
title_sort establishment of prognostic models for adenocarcinoma of oesophagogastric junction patients with neoadjuvant chemoradiotherapy: a real-world study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8896317/
https://www.ncbi.nlm.nih.gov/pubmed/35241109
http://dx.doi.org/10.1186/s13014-022-02016-3
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