Development and validation of a survival prediction model for patients with esophageal squamous cell carcinoma of the thoracic segment with pT1-2 lymph node metastasis

Abstract

Background: Research on predicting disease-specific survival (DSS) in patients with esophageal squamous cell carcinoma (ESCC) of the thoracic segment with pT1 to 2 lymph node metastases is insufficient. The nomogram is an excellent tool for individualized assessment. Methods: A total of 146 patients from Harbin Medical University Cancer Hospital were included in the training cohort. 478 patients from the SEER database were included in the validation cohort. Independent risk factors were analyzed through Cox proportional hazards regression, and a nomogram was developed to predict 3- and 5-year DSS. Prognostic efficacy was evaluated using area under the curve (AUC), calibration curves, and decision curve analysis (DCA) and validated in the SEER validation cohort. Results: In the training cohort of 146 cases, the median DSS and IQR (Q1-Q3) for patients with lymph node metastasis was 30.5 months (16.1-67.4 months). In the validation cohort of 478 cases, the median DSS and IQR (Q1-Q3) for patients with lymph node metastasis was 22 months (9-63 months). Predictors of DSS were identified using Cox univariate and multivariate analyses, with pT stage, grade, and chemotherapy identified as significant factors. Conclusion: We created a nomogram. Internal and external validation studies were performed. The time-dependent receiver operating characteristic (ROC) curve and AUC value, calibration curve, and DCA confirmed the high predictive ability of the nomogram. The newly developed nomogram can accurately forecast DSS in patients with thoracic segment ESCC and pT1-2 lymph node metastasis.