Development and validation of a nomogram for preoperative prediction of lymph node metastasis in pathological T1 esophageal squamous cell carcinoma
| Autor: | Ling Chen, MD, Kaiming Peng, MA, Ziyan Han, MA, Shaobin Yu, MA, Zhixin Huang, MA, Hui Xu, MA, Mingqiang Kang, MD, PHD, Jorddy Neves Cruz. |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Medicine, Vol 101, Iss 20, p e29299 (2022) |
| Druh dokumentu: | article |
| ISSN: | 0025-7974 1536-5964 00000000 |
| DOI: | 10.1097/MD.0000000000029299 |
| Popis: | Abstract. Endoscopic resection is increasingly used to treat patients with pathological T1 (pT1) esophageal squamous cell carcinoma (ESCC) because of its small surgical trauma. However, reports of the risk factors for lymph node metastasis (LNM) have been controversial. Therefore, we aim to build a nomogram to individually predict the risk of LNM in pT1 ESCC patients, to make an optimal balance between surgical trauma and surgical income. One hundred seventy patients with pT1 esophageal cancer in our hospital were analyzed retrospectively. Logistic proportional hazards models were conducted to find out the risk factor associated with LNM independently, and those were imported into R library “RMS” for analysis. A nomogram is generated based on the contribution weights of variables. Finally, decision analysis and clinical impact curve were used to determine the optimal decision point. Twenty-five (14.7%) of the 170 patients with pT1 ESCC exhibited LNM. Multivariable logistic regression analysis showed that smoking, carcinoembryonic antigen, vascular tumor thromboembolus, and tumor differentiation degree were independent risk factors for LNM. The nomogram had relatively high accuracy (C index of 0.869, 95% confidence interval: 0.794–0.914, P |
| Databáze: | Directory of Open Access Journals |
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