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Prognostic nomogram for patients undergoing oesophagectomy for adenocarcinoma of the oesophagus or gastro-oesophageal junction
- Source :
- British journal of surgery, 94(11), 1361-1368. John Wiley and Sons Ltd
- Publication Year :
- 2007
-
Abstract
- Background Tumour node metastasis (TNM) staging predicts survival on the basis of the pathological extent of a tumour. The aim of this study was to develop a prognostic model with improved survival prediction after oesophagectomy. Methods Consecutive patients who had potentially curative oesophagectomy for adenocarcinoma of the oesophagus or gastro-oesophageal junction were included. Cox regression analyses were performed to examine the association between risk factors and time to death from oesophageal cancer. The concordance index, calculated after bootstrapping, was used to measure accuracy. A nomogram was designed for use in clinical practice. Results Oesophageal cancer-specific survival rates for the 364 included patients who underwent oesophagectomy between 1993 and 2003 were 75·8, 54·9 and 39·2 per cent at 1, 2 and 5 years respectively. A prognostic model using all prognostic variables outperformed TNM staging (concordance index 0·79 versus 0·68 respectively; P < 0·001). A reduced model derived after backward elimination, containing only T stage, lymph node ratio and extracapsular lymph node involvement, also outperformed TNM staging (concordance index 0·77; P < 0·001). Conclusion A prognostic model developed to predict disease-specific survival after oesophagectomy was superior to TNM staging. More reliable prognostic information might lead to different approaches to patient follow-up.
- Subjects :
- Male
medicine.medical_specialty
Prognostic variable
Esophageal Neoplasms
medicine.medical_treatment
Adenocarcinoma
Gastroenterology
Cohort Studies
Risk Factors
Stomach Neoplasms
Internal medicine
medicine
Humans
Survival rate
Survival analysis
Aged
Proportional hazards model
business.industry
Nomogram
Esophageal cancer
Middle Aged
medicine.disease
Prognosis
Survival Analysis
Esophagectomy
Nomograms
Treatment Outcome
T-stage
Surgery
Female
Esophagogastric Junction
business
Subjects
Details
- ISSN :
- 13652168 and 00071323
- Volume :
- 94
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The British journal of surgery
- Accession number :
- edsair.doi.dedup.....7103ddad4c4b8fbc233696f693e78239