Background. Esophageal cancer is one of the leading causes of cancer-related death worldwide. Despite the significant progress in the overall treatment of esophageal cancer in recent years, the prognosis for patients who require surgery remains poor. Methods. The present study investigated the clinicopathological features of 503 patients who underwent radical esophagectomy at Huashan Hospital of Fudan University between January 2005 and January 2015. Nomograms that predicted the esophageal squamous cell carcinoma (ESCC) survival rates were established using the Cox proportional hazard regression model. Discrimination and calibration, which were calculated after bootstrapping, were used as a measure of accuracy. Results. Multivariate analyses were used to select five independent prognostic variables and build the nomogram. These variables were pathological T stage, pathological N factor, rate of positive LNs, history of chronic obstructive pulmonary disease (COPD) and postoperative sepsis. The nomogram was built to predict the rates for overall survival (OS) and disease-free survival (DFS). The concordance index for the nomogram prediction for OS and DFS was 0.720 and 0.707, respectively. Compared to the conventional TNM staging system, the nomogram had better predictive accuracy for survival (OS 0.720 vs. 0.672, ; DFS 0.707 vs. 0.667; ). Conclusions. The present study incorporated pathological T stage, pathological N factor, rate of positive LNs, history of COPD, and postoperative sepsis into a nomogram to predict the OS and DFS of ESCC patients. This practical system may help clinicians in both decision-making and clinical study design. The assessment of lung function for patients with COPD preoperative, and the control of disease progression are needed. Furthermore, the postoperative infection of patients should be controlled. Further studies may help to extend the validation of this method and improve the model through parameter optimization.

中文翻译：

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食管鳞状细胞癌根治性食管切除术后个体生存的预测


背景。食管癌是全球癌症相关死亡的主要原因之一。尽管近年来食管癌的整体治疗取得了显着进展，但需要手术的患者的预后仍然较差。方法。本研究调查了2005年1月至2015年1月期间在复旦大学附属华山医院接受根治性食管切除术的503例患者的临床病理特征。利用Cox比例风险回归模型建立了预测食管鳞状细胞癌（ESCC）生存率的列线图。自举后计算的辨别和校准被用作准确性的衡量标准。结果。使用多变量分析来选择五个独立的预后变量并构建列线图。这些变量是病理T分期、病理N因子、LN阳性率、慢性阻塞性肺病（COPD）病史和术后脓毒症。列线图旨在预测总生存率 (OS) 和无病生存率 (DFS)。 OS 和 DFS 列线图预测的一致性指数分别为 0.720 和 0.707。与传统的 TNM 分期系统相比，列线图对生存具有更好的预测准确性（OS 0.720 vs. 0.672， ; DFS 0.707 与 0.667； ）。结论。 本研究将病理 T 分期、病理 N 因子、LN 阳性率、COPD 病史和术后脓毒症纳入列线图，以预测 ESCC 患者的 OS 和 DFS。这个实用的系统可以帮助临床医生进行决策和临床研究设计。术前需要对COPD患者进行肺功能评估，控制疾病进展。此外，还应控制患者的术后感染。进一步的研究可能有助于扩展该方法的验证并通过参数优化改进模型。