• Wenlei Yang, Fangfang Liu, Ruiping Xu, Wei Yang, Yu He, Zhen Liu, Fuyou Zhou, Fanxiu Heng, Bolin Hou, Lixin Zhang, Lei Chen, Fan Zhang, Fen Cai, Huawen Xu, Miaoping Lin, Mengfei Liu, Yaqi Pan, Ying Liu, Zhe Hu, Huanyu Chen, Zhonghu He, and Yang Ke.
• Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
• Ann. Surg. 2023 Jan 1; 277 (1): e61e69e61-e69.

ObjectiveTo construct a prediction model for more precise evaluation of prognosis which will allow personalized treatment recommendations for adjuvant therapy in patients following resection of ESCC.BackgroundMarked heterogeneity of patient prognosis and limited evidence regarding survival benefit of various adjuvant therapy regimens pose challenges in the clinical treatment of ESCC.MethodsBased on comprehensive clinical data obtained from 4129 consecutive patients with resected ESCC in a high-risk region in China, we identified predictors for overall survival through a 2-phase selection based on Cox proportional hazard regression and minimization of Akaike information criterion. The model was internally validated using bootstrapping and externally validated in 1815 patients from a non-high-risk region in China.ResultsThe final model incorporates 9 variables: age, sex, primary site, T stage, N stage, number of lymph nodes harvested, tumor size, adjuvant treatment, and hemoglobin level. A significant interaction was also observed between N stage and adjuvant treatment. N1+ stage patients were likely to benefit from addition of adjuvant therapy as opposed to surgery alone, but adjuvant therapy did not improve overall survival for N0 stage patients. The C -index of the model was 0.729 in the training cohort, 0.723 after bootstrapping, and 0.695 in the external validation cohort. This model outperformed the seventh edition American Joint Committee on Cancer staging system in prognostic prediction and risk stratification.ConclusionsThe prediction model constructed in this study may facilitate precise prediction of survival and inform decision-making about adjuvant therapy according to N stage.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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