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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2022; 14(8): 788-798
Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.788
Model established based on blood markers predicts overall survival in patients after radical resection of types II and III adenocarcinoma of the esophagogastric junction
Zhi-Jian Wei, Ya-Ting Qiao, Bai-Chuan Zhou, Abigail N Rankine, Li-Xiang Zhang, Ye-Zhou Su, A-Man Xu, Wen-Xiu Han, Pan-Quan Luo
Zhi-Jian Wei, Bai-Chuan Zhou, Li-Xiang Zhang, A-Man Xu, Wen-Xiu Han, Pan-Quan Luo, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Ya-Ting Qiao, Department of Gastrointestinal Surgery, Affiliated Hospital of HeBei University, Baoding 071000, Hebei Province, China
Abigail N Rankine, Department of Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China
Li-Xiang Zhang, Department of Gastroenterology, Anhui Provincial Key Laboratory of Digestive Disease, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Ye-Zhou Su, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Wei ZJ and Qiao YT designed this study and drafted the manuscript, and they contributed to this work equally; Zhou BC collected and organized the data; Abigail NR polished the article; Zhang LX, Su YZ, Xu AM, Han WX, and Luo PQ performed the study and participated in the work; Zhang LX, Su YZ, Xu AM, Han WX, and Luo PQ contributed this work equally, and they are all the corresponding author. All authors read and approved the final manuscript.
Supported by the Natural Science Foundation of Anhui Province, No. 2108085QH337.
Institutional review board statement: This study was approved by the First Affiliated Hospital of Anhui Medical University.
Conflict-of-interest statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Pan-Quan Luo, MM, Surgeon, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230022, Anhui Province, China. xamlpqdoctor@163.com
Received: February 11, 2022
Peer-review started: February 11, 2022
First decision: April 19, 2022
Revised: April 30, 2022
Accepted: August 5, 2022
Article in press: August 5, 2022
Published online: August 27, 2022
ARTICLE HIGHLIGHTS
Research background
In recent years, the incidence of types II and III adenocarcinoma of the esophagogastric junction (AEG) has shown an obvious upward trend worldwide.
Research motivation
The prognostic prediction after radical resection of AEG has not been well established.
Research objectives
To establish a prognostic model for AEG (types II and III) based on routine markers.
Research methods
The construction of the nomogram was based on Cox proportional-hazards models. The new score model was analyzed by C index and calibration curves. The receiver operating characteristic (ROC) curve was used to compare the predictive accuracy of the scoring system and tumor-node-metastasis (TNM) staging. Overall survival (OS) was calculated using the Kaplan-Meier curve amongst different risk AEG patients.
Research results
Multivariate analysis showed that TNM stage (hazard ratio [HR] = 2.286, P = 0.008), neutrophil-to-lymphocyte ratio (NLR) (HR = 2.979, P = 0.001), and body mass index (BMI) (HR = 0.626, P = 0.026) were independent prognostic factors. The new scoring system had a higher concordance index (0.697), and the calibration curves of the nomogram were reliable. The area under the ROC curve of the new score model (3-year: 0.725, 95% confidence interval [CI]: 0.676-0.777; 5-year: 0.758, 95%CI: 0.708-0.807) was larger than that of TNM staging (3-year: 0.630, 95%CI: 0.585-0.684; 5-year: 0.665, 95%CI: 0.616-0.715).
Research conclusions
This model has been identified as a new standard that can integrate multiple predictive variables in a weighted manner and intuitively show the influence of variables on individual predictive values. To the best of our knowledge, this study is the first attempt to develop a prognostic nomogram that combines serum markers (including inflammatory markers, nutritional indices, and tumor markers) and clinicopathological characteristics to estimate the 3-year and 5-year survival probability, which is highly accurate in predicting the prognosis of patients with AEG (types II and III). TNM stage, NLR, and BMI were risk factors for the prognosis of patients with AEG and then a model was built which can predict the prognosis of patients.
Research perspectives
The novel nomogram accurately and reliably predicts the OS after radical resection of patients with AEG (types II and III). This may help clinicians formulate personalized treatment plans.
