Development and validation of a nomogram for prediction of cervical lymph node metastasis in middle and lower thoracic esophageal squamous cell carcinoma

Abstract

Background Estimates of cervical lymph node (LN) metastasis in patients with middle and lower thoracic esophageal squamous cell carcinoma (ESCC) are important. A nomogram is a useful tool for individualized prediction. Methods A total of 235 patients were enrolled in this study. Univariate and multivariate analyses were performed to screen for independent risk factors and construct a nomogram to predict the risk of cervical LN metastasis. The nomogram performance was assessed by discrimination, calibration, and clinical use. Results Totally, four independent predictors, including the maximum diameter of tumor, paraesophageal lymph node status, recurrent laryngeal nerve lymph node status, and the CT-reported cervical LN status, were enrolled in the nomogram. The AUC of the nomogram model in the training and validation dataset were 0.833 (95% CI 0.762–0.905), 0.808 (95% CI 0.696–0.920), respectively. The calibration curve demonstrated a strong consistency between nomogram and clinical findings in predicting cervical LN metastasis. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion We developed a nomogram that could be conveniently used to predict the individualized risk of cervical LN metastasis in patients with middle and lower thoracic ESCC.

Development and validation of nodal staging score in pN0 patients with esophageal squamous cell carcinoma: A population study from the SEER database and a single‐institution cohort

“…Previous studies have indicated that T stage, histopathology, differentiation grade, tumor size, and neoadjuvant therapy are the main factors affecting LNM in EC. 7 , 14 , 15 , 16 , 17 , 18 T stage was the most crucial factor for LNM in ESCC 19 : the deeper the tumor invasion, the easier it is for the tumor cells to enter the lymphatic vessels. Consequently, LNM rates have significantly improved.…”

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

“…Our study focused on patients with ESCC of the thoracic segment with pT1 ~ 2 lymph node metastasis, which allows for further re nement of previous studies. In another analysis that predicted positive esophageal lymphadenopathy decision making, the nomogram was used to predict the likelihood of cervical lymph node metastasis from ESCC in the lower mid-thoracic region, but further studies on patient survival were lacking [15]. Other studies, exploring the clinicopathological features of pT1N0 ESCC associated with tumor recurrence and constructing a clinical prediction model to predict early recurrence [16].…”