Nomograms for predicting survival in early-onset esophageal cancer

ABSTRACT

Background: This study aimed to develop nomograms predicting the overall survival (OS) of patients younger than 50 years old with esophageal cancer.

Methods: We selected patients included 2004–2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed using significant variables from multivariable Cox analyses. The discrimination and calibration power of the models were evaluated using concordance indexes (C-indexes) and calibration curves. Decision curve analysis was used to assess the clinical net benefits of the nomograms.

Results: Of 1,997 selected patients, 53.2% had advanced-stage tumor. Race, grade, T stage, N stage, and treatment were independent factors affecting OS in early-stage patients. The C-indexes of the corresponding nomogram were 0.710 (95% CI = 0.684–0.736) and 0.681 (95% CI = 0.640–0.722) in training and validation sets, respectively. Grade, marital status, and treatment were independent factors affecting OS in advanced-stage patients. The C-indexes of the corresponding nomogram were 0.677 (95% CI = 0.653–0.701) and 0.675 (95% CI = 0.638–0.712) in training and validation sets, respectively. Calibration curves demonstrated high consistency between predicted and actual survival.

Conclusion: We constructed and verified nomograms that could accurately predict the survival rate of esophageal cancer in patients younger than 50 years old. This may help clinicians better understand prognostic factors.

KEYWORDS:

• Early-onset
• esophageal cancer
• nomogram
• prognosis
• SEER program

Author contributions

Min Shi was involved in the conception and design, the drafting of the paper or revising it critically for intellectual content. Jian-wei Tang was involved in the analysis and interpretation of the data. Zhi-rong Cao was involved in the final approval of the version to be published. All authors agreed to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.