231P - Nomogram to predict prognosis in thoracic esophageal squamous cell carcinoma after neoadjuvant radiotherapy or chemoradiotherapy

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Oesophageal Cancer
Surgical Oncology
Presenter Wei Deng
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors W. Deng1, Q. Wang2, Z. Xiao1, L. Tan3, Z. Zhou1, H. Zhang1, D. Chen1, Q. Feng1, J. Liang1, J. He4, S. Gao4, K. Sun4, G. Cheng4, X. Liu4, D. Fang4, Q. Xue4, Y. Mao4, D. Wang4, J. Li4
  • 1Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS), 100021 - Beijing/CN
  • 2Radiation Oncology, Sichuan Cancer Hospital, 610041 - Chengdu/CN
  • 3Radiation Oncology, 1st Hospital of Harbin Medical University, 150001 - Harbin/CN
  • 4Surgical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS), 100021 - Beijing/CN

Abstract

Background

It is considered not accurate enough to adopt AJCC staging system to evaluate the survival of patients with esophageal squamous cell carcinoma after neoadjuvant radiotherapy or chemoradiotherapy. Our study aims to establish a nomogram for prognosis estimating and instruction about successive treatment.

Methods

We retrospectively reviewed 407 patients who diagnosed with thoracic esophageal squamous cell carcinoma (TESCC) and received neoadjuvant radiotherapy or chemoradiotherapy from 1980 to 2014. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of categorical age, sex, tumor length, treatment response, lymph node status, resection margin, proximal margin length and anastomotic leakage with overall survival (OS) were calculated using Cox proportional hazard model. Then, the nomogram and recursive partitioning analysis (RPA) model were established respectively, total scores according to each variables were calculated and stratified to predict OS respectively.

Results

Four hundred and seven patients were followed-up over a median 26.0 months (49.9months for censor cases). The five year OS and disease free survival (DFS) were 36.7%, 36.1% with median survival time 31.0 and 23.0 months respectively. AJCC 2009 staging system did not performance well in distinguishing OS except IIB and IIIA(p = 0.005). Patients were divided into 4 groups according to the total scores based on nomogram (group A: ≤180; group B: 180-270; group C: 270-340; group D: >340). The 5 year OS was 57.3%, 40.7%, 18.3%, 6.1%, respectively and DFS was 57.4%, 40.8%, 18.3%, 6.0%, each group shows statistically different prognosis. RPA model indicated that lymph node status, proximal margin length and treatment response were the best prognostic factors, but group 2 and 3 in the 4 groups were not statistically significant (p = 0.574).

Conclusions

The nomogram is a good predictor for prognosis in patients with TESCC after neoadjuvant radiotherapy or chemoradiotherapy. AJCC cancer staging system does not accurately identify each groups. RPA model is not good as nomogram in this patient group. Although need more studies to confirm, this nomogram indicates further treatment may be applied to the high risk subgroup.

Clinical trial indentification

NA

Legal entity responsible for the study

Zefen Xiao

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.