Dataset Information

Clinical features and prognostic factors of esophageal signet ring cell carcinoma: construction and validation of a model based on the SEER database.

ABSTRACT:

Background

Signet ring cell carcinoma (SRCC) of the esophagus is a rare subtype of esophagus cancer with a poor prognosis. Our study aimed to determine the prognostic factors and establish nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with esophageal SRCC.

Methods

A total of 401 esophageal SRCC patients were identified from Surveillance Epidemiology and End Results (SEER) database and randomly divided into training and validation groups. We integrated the significant prognostic factors identified by multivariate cox analysis and construct nomograms to predict 2- and 5-year OS and CSS. Then, we evaluated the performance of the nomograms through concordance index (C-index), calibration curve, and the area under the curve (AUC) of the receiver operating characteristic curve.

Results

Multivariate Cox analysis revealed that American Joint Committee on Cancer (AJCC) stage, chemotherapy and surgery were associated with both OS and CSS. The C-indexes for OS and CSS predicted nomograms were 0.773 and 0.806, respectively. The calibration curves demonstrated good agreement between the actual observation and the nomogram prediction. Furthermore, the novel nomograms displayed higher AUC values in predicting OS and CSS compared to the 7th Tumor-Node-Metastasis (TNM) staging system.

Conclusions

AJCC stage, chemotherapy and surgery were independent prognostic factors in esophageal SRCC patients. The proposed three-factor nomogram can assist clinicians predict the accurate prognosis of esophageal SRCC, thus contributing to individualized clinical practice.

SUBMITTER: Xie R

PROVIDER: S-EPMC9641096 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Clinical features and prognostic factors of esophageal signet ring cell carcinoma: construction and validation of a model based on the SEER database.

Xie Rongrong R Lu Guangrong G Li Lili L

Translational cancer research 20221001 10

<h4>Background</h4>Signet ring cell carcinoma (SRCC) of the esophagus is a rare subtype of esophagus cancer with a poor prognosis. Our study aimed to determine the prognostic factors and establish nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with esophageal SRCC.<h4>Methods</h4>A total of 401 esophageal SRCC patients were identified from Surveillance Epidemiology and End Results (SEER) database and randomly divided into training and validation groups ...[more]

PMID: 36388034

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Project description:BackgroundEsophageal neuroendocrine carcinoma (ENEC) is a rare subtype of esophageal cancer (EC). It presents distinctive clinical and pathological features in comparison to esophageal squamous cell carcinoma (ESCC). To better elucidate the disparities between the two and establish a prognostic prediction model for ENEC, we conducted this study.MethodsData of ENEC and ESCC patients (1975 to 2016) were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Patients with a confirmed pathological diagnosis of ENEC and ESCC were enrolled in the study. The Chi-square test was employed to compare categorical variables, and the median survival time was analyzed using the Kaplan-Meier curve. Training and validation groups were randomly assigned at a ratio of 7:3. Factors with a significance level of <0.05 in the multifactor regression model as well as age were integrated into the nomogram model. Concordance index (C-index), calibration curves, and decision curve analyses (DCA) were generated for model validation.ResultsThis study encompassed a total of 737 ENEC patients and 29,420 ESCC. Compared to ESCC, ENEC patients had higher probability of liver metastasis (13.8% vs. 1.9%, P<0.001), poor differentiation (68.0% vs. 37.1%, P<0.001), and late SEER stage (52.8% vs. 26.9%, P<0.001). Patients who received either surgery, radiotherapy (RT), or chemotherapy had a significantly longer disease-specific survival (DSS) and overall survival (OS) (all P<0.001). After propensity score matching (PSM), ENEC patients were associated with shorter DSS (7.0 months vs. not reached, P<0.0001) and OS (7.0 vs. 12.0 months, P<0.0001) compared to ESCC. Race, SEER stage, surgery, RT, and chemotherapy were identified as predictors of DSS and were incorporated into the nomogram model together with age. The validation of the model using C-index (0.751 and 0.706, respectively) and calibration curves reflected the better discrimination power of the model. In addition, DCA supported the favorable potential clinical effect of the predictive model. Lastly, a risk classification based on the nomogram also verified the reliability of the model.ConclusionsENEC and ESCC exhibit distinct clinicopathological features. Patients with ENEC experience significantly poorer survival outcomes compared to those with ESCC. Surgical intervention, radiation therapy, and chemotherapy significantly improve OS and DSS for ENEC patients. The nomogram prediction model, constructed based on age, race, stage, and treatment regimen, demonstrates accurate and effective predictive capabilities for prognostic factors in ENEC patients.

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Dataset Information

Clinical features and prognostic factors of esophageal signet ring cell carcinoma: construction and validation of a model based on the SEER database.

Background

Methods

Results

Conclusions

Publications

Clinical features and prognostic factors of esophageal signet ring cell carcinoma: construction and validation of a model based on the SEER database.

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