Cardiothoracic Surgery |

Nomogram for Predicting Lymph Node Metastasis for Patients With T1 Esophageal Carcinoma FREE TO VIEW

Su Yang, MD
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Ruijin Hospital Shanghai Jiaotong University, School of Medcine, Shanghai, China

Chest. 2015;148(4_MeetingAbstracts):39A. doi:10.1378/chest.2230958
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SESSION TITLE: Thoracic Surgery

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 28, 2015 at 04:30 PM - 05:30 PM

PURPOSE: The optimal management for patients with T1 esophageal carcinoma is still under debate. We developed a nomogram to predict lymph node status in T1 esophageal squamous carcinoma and adenocarcinoma and stratify patients who need further treatment.

METHODS: Patients diagonosed with pT1NxM0 esophageal squamous cell carcinoma and adenocarcinoma between 1988-2010 were selected from the Surveillance, Epidemiology, and End Result(SEER) database. All patients underwent primary tumor resection and regional lymphadenectomy. A multivariate logistic model was created from preoperative clinicopathologic data of the patients between 1988-2008,and a nomogram to predict lymph node metastasis was constructed. A cohort of patients diagonosed between 2009-2010 was used for external validation.

RESULTS: The final model presented as a nomogram included T stage, grade, age and tumor size. The nomogram incorporating these four predictors demonstrated good discrimination (concordance index 0.69). In the validation cohort, the discrimination accuracy was 0.74 . After 200 repetitions, the bootstrap corrected concordance index of the model was 0.68 in the model-development cohort.

CONCLUSIONS: A nomogram predicting lymph node status in T1 esophageal squamous cell carcinoma and adenocarcinoma was developed. This model will help physicians to assess the risk of lymph node metastasis and decide whether lymphadenectomy should be performed.

CLINICAL IMPLICATIONS: Clinical physician can calculate a total score according to the parameters of the nomogram. This score could then be used to value the probability of LN metastasis for individual patient corresponding to the scale at the bottom of the nomogram.

DISCLOSURE: The following authors have nothing to disclose: Su Yang

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