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A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy
BACKGROUND: This study aimed to establish a reliable model for predicting the overall survival (OS) of esophageal squamous cell carcinoma (ESCC) patients and identifying the potential beneficiaries of adjuvant chemotherapy after esophagectomy. METHODS: This retrospective study included 819 ESCC pati...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908144/ https://www.ncbi.nlm.nih.gov/pubmed/35280404 http://dx.doi.org/10.21037/atm-22-46 |
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author | Zhou, Zihao Huang, Shujie Ben, Xiaosong Zhuang, Weitao Hong, Liangli Xie, Zefeng Zhang, Dongkun Xie, Liang Zhou, Haiyu Tang, Jiming Chen, Gang Wu, Hansheng Qiao, Guibin |
author_facet | Zhou, Zihao Huang, Shujie Ben, Xiaosong Zhuang, Weitao Hong, Liangli Xie, Zefeng Zhang, Dongkun Xie, Liang Zhou, Haiyu Tang, Jiming Chen, Gang Wu, Hansheng Qiao, Guibin |
author_sort | Zhou, Zihao |
collection | PubMed |
description | BACKGROUND: This study aimed to establish a reliable model for predicting the overall survival (OS) of esophageal squamous cell carcinoma (ESCC) patients and identifying the potential beneficiaries of adjuvant chemotherapy after esophagectomy. METHODS: This retrospective study included 819 ESCC patients who underwent esophagectomy as the training cohort. We constructed a prognostic model named GTLN2. Both internal and external validation tests were performed. Potential beneficiaries were defined as ESCC patients who obtained a significantly longer OS after adjuvant chemotherapy. Propensity score matching (PSM) was utilized in the subgroup analysis to screen ESCC beneficiaries of adjuvant chemotherapy. RESULTS: We enrolled a total of 819 cT1b-3 patients in the training cohort. Multiple prognostic factors were associated with adjuvant chemotherapy. Using uni-/multivariate analysis, histological grade (G), tumor invasion depth (T), regional lymph node metastasis (N), and the number of cleared lymph nodes (NCLNs) were identified as independent prognostic factors. Then, we developed the GTLN2 model based on these predictors and validated it using internal calculations [the 1-, 3- and 5-year area under the curves (AUCs) were 0.692, 0.685 and 0.680, respectively; P<0.001] and external cohorts (the 1-, 3-, and 5-year AUCs were 0.651, 0.619 and 0.650, respectively; P<0.001). ESCC patients were categorized into high- and low-risk groups based on their assigned risk scores. After 1:1 patient pairing was performed by PSM in the high-risk group, better OS was noted in patients receiving adjuvant chemotherapy (P=0.024). CONCLUSIONS: Differentiating high- and low-risk patient groups via a novel mathematical prediction model allows physicians to identify patients in need of adjuvant chemotherapy accurately. |
format | Online Article Text |
id | pubmed-8908144 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-89081442022-03-11 A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy Zhou, Zihao Huang, Shujie Ben, Xiaosong Zhuang, Weitao Hong, Liangli Xie, Zefeng Zhang, Dongkun Xie, Liang Zhou, Haiyu Tang, Jiming Chen, Gang Wu, Hansheng Qiao, Guibin Ann Transl Med Original Article BACKGROUND: This study aimed to establish a reliable model for predicting the overall survival (OS) of esophageal squamous cell carcinoma (ESCC) patients and identifying the potential beneficiaries of adjuvant chemotherapy after esophagectomy. METHODS: This retrospective study included 819 ESCC patients who underwent esophagectomy as the training cohort. We constructed a prognostic model named GTLN2. Both internal and external validation tests were performed. Potential beneficiaries were defined as ESCC patients who obtained a significantly longer OS after adjuvant chemotherapy. Propensity score matching (PSM) was utilized in the subgroup analysis to screen ESCC beneficiaries of adjuvant chemotherapy. RESULTS: We enrolled a total of 819 cT1b-3 patients in the training cohort. Multiple prognostic factors were associated with adjuvant chemotherapy. Using uni-/multivariate analysis, histological grade (G), tumor invasion depth (T), regional lymph node metastasis (N), and the number of cleared lymph nodes (NCLNs) were identified as independent prognostic factors. Then, we developed the GTLN2 model based on these predictors and validated it using internal calculations [the 1-, 3- and 5-year area under the curves (AUCs) were 0.692, 0.685 and 0.680, respectively; P<0.001] and external cohorts (the 1-, 3-, and 5-year AUCs were 0.651, 0.619 and 0.650, respectively; P<0.001). ESCC patients were categorized into high- and low-risk groups based on their assigned risk scores. After 1:1 patient pairing was performed by PSM in the high-risk group, better OS was noted in patients receiving adjuvant chemotherapy (P=0.024). CONCLUSIONS: Differentiating high- and low-risk patient groups via a novel mathematical prediction model allows physicians to identify patients in need of adjuvant chemotherapy accurately. AME Publishing Company 2022-02 /pmc/articles/PMC8908144/ /pubmed/35280404 http://dx.doi.org/10.21037/atm-22-46 Text en 2022 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Zhou, Zihao Huang, Shujie Ben, Xiaosong Zhuang, Weitao Hong, Liangli Xie, Zefeng Zhang, Dongkun Xie, Liang Zhou, Haiyu Tang, Jiming Chen, Gang Wu, Hansheng Qiao, Guibin A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title | A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title_full | A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title_fullStr | A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title_full_unstemmed | A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title_short | A novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
title_sort | novel prognostic model: which group of esophageal squamous cell carcinoma patients could benefit from adjuvant chemotherapy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908144/ https://www.ncbi.nlm.nih.gov/pubmed/35280404 http://dx.doi.org/10.21037/atm-22-46 |
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