Nomogram for prognosis of patients with esophageal squamous cell cancer after minimally invasive esophagectomy established based on non-textbook outcome

Xu, Shao-Jun; Lin, Lan-Qin; Chen, Ting‐Yu; You, Cheng-Xiong; Chen, Chao; Chen, Rui-Qin; Chen, Shu-chen

doi:10.1007/s00464-022-09290-y

Cited by 4 publications

(2 citation statements)

References 41 publications

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“…The nomogram can markedly improve the ability to predict the survival of cancer patients by integrating the different prognostic factors and has been widely used in clinical practice [25,26]. In the present study, we found that SPC, pathological TNM stage, and intraoperative blood loss in the high NPS status were independent indicators for the prognosis in ESCC patients.…”

Section: Discussionsupporting

confidence: 50%

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Wang

Chen

et al. 2023

World j. surg.

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Introduction The potential association between severe postoperative complications (SPC) and the oncological outcomes of esophageal squamous cell carcinoma (ESCC) patients according to the different Naples Prognostic Score (NPS) of the inflammatory nutritional status after minimally invasive esophagectomy (MIE) is unclear. Methods Kaplan–Meier survival analysis was used to evaluate overall survival (OS) and disease‐free survival (DFS) between with or without SPC (Clavien–Dindo grade ≥ III) in low NPS status (NPS = 0 or 1) and high NPS status (NPS = 2 or 3 or 4) patients. Cox multivariable analysis was carried out to analyze the various independent factors of OS and DFS, and a nomogram based on SPC was established. Results A total of 20.7% (125/604) ESCC patients developed SPC after MIE. Patients with SPC exhibited poor 5‐year OS and DFS compared to those without SPC (all P < 0.001). Further analysis revealed that SPC significantly reduced OS and DFS in patients with high NPS status (all P < 0.001) but had little effect on the prognosis of patients with low NPS status (all P > 0.05). Multivariable Cox analysis revealed that SPC could be an independent influence indicator for OS and DFS in patients with high NPS status. Therefore, a novel nomogram combining SPC and tumor‐node‐metastasis (TNM) staging has been developed, which was found to be relatively more accurate in predicting OS and DFS than TNM staging alone. Conclusion Severe complications can adversely affect the long‐term oncological outcome of ESCC patients with high systemic inflammatory response and malnutrition after MIE.

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Section: Discussionsupporting

confidence: 50%

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Wang

Chen

et al. 2023

World j. surg.

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“…In contrast, the complexity of both multimodal treatment components and TO measures implies difficulty in data synthesis and analysis. Machine learning approach 38 and development of normograms 39 based on TO have allowed further advancements in the standardization of multimodal treatment quality assessment.…”

Section: Discussionmentioning

confidence: 99%

Textbook Oncological Outcome in European Gastrodata

et al. 2023

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Objective: To assess the rate of textbook outcome (TO) and textbook oncological outcome (TOO) in European population based on Gastrodata registry. Background: TO is a composite parameter assessing surgical quality and strongly correlates with improved overall survival. Following the standard of treatment for locally advanced gastric cancer (GC), TOO was proposed as a quality and optimal multimodal treatment parameter. Methods: TO was achieved when all the following criteria were met: no intraoperative complications, radical resection according to the surgeon, pR0 resection, retrieval of at least 15 lymph nodes, no severe postoperative complications, no reintervention, no admission to the intensive care unit, no prolonged length of stay, no postoperative mortality and no hospital readmission. TOO was defined as TO with addition of perioperative chemotherapy compliance. Results: From the 2558 patients, 1700 were included in the analysis. TO was achieved in 1164 (68.5%) patients. The use of neoadjuvant chemotherapy (OR=1.33, 95%CI: 1.04-1.70) and D2 or D2+ lymphadenectomy (OR=1.55, 95%CI: 1.15-2.10) had a positive impact on TO achievement. Older age (OR=0.73, 95%CI: 0.54-0.94), pT3/4 (OR=0.79, 95%CI: 0.63-0.99), ASA 3/4 (OR=0.68, 95%CI: 0.54-0.86) and total gastrectomy (OR=0.56, 95%CI: 0.45-0.70), had negative impact on TO achievement. TOO was achieved in 388 (22.8%) patients. Older age (OR=0.37, 95%CI: 0.27-0.53), pT3-pT4 (OR=0.52, 95%CI: 0.39-0.69) and ASA 3-4 (OR=0.58, 95%CI: 95%CI: 0.43-0.79) had negative impact on TOO achievement. Conclusion: Despite successively improved surgical outcomes, stage‐appropriate chemotherapy in adherence to the current guidelines for multimodal treatment of GC remains poor. Further implementation of oncologic quality metrics should include greater emphasis on perioperative chemotherapy and adequate lymphadenectomy.

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Impact of minimally invasive total mesoesophageal excision and minimally invasive esophagectomy on failure patterns of locally advanced esophageal squamous cell carcinoma: a matched cohort study with long-term follow-up

Lin,

Xu,

Chen

et al. 2023

Surg Endosc

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Nomogram for prognosis of patients with esophageal squamous cell cancer after minimally invasive esophagectomy established based on non-textbook outcome

Cited by 4 publications

References 41 publications

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Textbook Oncological Outcome in European Gastrodata

Impact of minimally invasive total mesoesophageal excision and minimally invasive esophagectomy on failure patterns of locally advanced esophageal squamous cell carcinoma: a matched cohort study with long-term follow-up

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