Survival nomogram for patients with metastatic siewert type II adenocarcinoma of the esophagogastric junction: a population-based study

ABSTRACT

Background

The aim of this study was to construct a nomogram to predict the survival of patients with metastatic Siewert Type II adenocarcinomas of the esophagogastric junction (AEG).

Methods

Patients were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Cox regression analysis was performed to assess the prognostic factors. A nomogram comprising independent prognostic factors was established and evaluated using C-indexes, calibration curves, and decision curve analyses.

Results

In total 1616 eligible patients were enrolled. Race, age, bone metastasis, liver metastasis, lung metastasis, other metastasis sites, and distant lymph nodes metastasis were independent prognostic factors and were integrated to construct the nomogram. The nomogram had a C-index of 0.590 (95% CI: 0.569–0.611) in the training cohort and 0.569 (95% CI: 0.532–0.606) in the validation cohort. The calibration plots for the probabilities of 6-month and 1-year overall survival demonstrated there was an optimum between nomogram prediction and actual observation.

Conclusion

We developed and validated a nomogram to predict individual prognosis for patients with metastatic Siewert Type II AEG, and the risk stratification system based on the nomogram could effectively stratify the patients into two risk subgroups, which can help clinicians accurately predict mortality risk and recommend personalized treatment modalities.

KEYWORDS:

• Nomogram
• esophagogastric junction
• distant metastases
• prognosis
• SEER database

Author contributions

Contributions: (I) Conception and design: All authors; (II) Administrative support: D Cheng; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: K Chen; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

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.

Data availability statement

The data that support the findings of this study are openly available in the SEER database at https://seer.cancer.gov/seerstat/.

Additional information

Funding

The study was supported by the Natural Science Foundation of Zhejiang Province (No. LQ17H260004) and Wenzhou Municipal Science and Technology Bureau (No. Y20180175).