Published online Jan 15, 2025. doi: 10.4251/wjgo.v17.i1.96686
Revised: September 2, 2024
Accepted: September 9, 2024
Published online: January 15, 2025
Processing time: 213 Days and 2.1 Hours
Esophageal carcinoma (EC) presents a significant public health issue in China, with its prognosis impacted by myriad factors. The creation of a reliable prog
To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.
This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1, 2018, and December 12, 2020. Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model. Its efficacy was assessed by concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).
Nine variables were determined to be significant predictors of OS in EC patients: Body mass index (BMI), Karnofsky performance status, TNM stage, surgery, radiotherapy, chemotherapy, immunotherapy, platelet-to-lymphocyte ratio, and albumin-to-globulin ratio (ALB/GLB). The model demonstrated a C-index of 0.715 (95%CI: 0.701-0.729) in the training cohort and 0.711 (95%CI: 0.689-0.732) in the validation cohort. In the training cohort, AUCs for 1-year, 3-year, and 5-year OS predictions were 0.773, 0.787, and 0.750, respectively; in the validation cohort, they were 0.772, 0.768, and 0.723, respectively, illustrating the model's precision. Calibration curves and DCA verified the model's predictive accuracy and net benefit.
A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
Core Tip: In this study, we identified nine key independent risk factors associated with esophageal carcinoma patients. These factors span clinical characteristics (body mass index, Karnofsky performance status), the TNM stage, treatment approaches (surgery, radiotherapy, chemotherapy, and immunotherapy), and laboratory markers (platelet-to-lymphocyte ratio, albumin-to-globulin ratio). And then, a novel prognostic model was successfully developed and validated. It could be considered as a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.