A Nomogram Based on Nutrition-Related Indicators and Computed Tomography Imaging Features for Predicting Preoperative Lymph Node Metastasis in Curatively Resected Esophagogastric Junction Adenocarcinoma.

Can-Tong Liu, Yu-Hui Peng, Chao-Qun Hong, Xin-Yi Huang, Ling-Yu Chu, Yi-Wei Lin, Hai-Peng Guo, Fang-Cai Wu, Yi-Wei Xu

Journal: Annals of surgical oncology 2023;30(8):5185-5194

PMID: 37010663

Abstract

BACKGROUNDS

Preoperative noninvasive tools to predict pretreatment lymph node metastasis (PLNM) status accurately for esophagogastric junction adenocarcinoma (EJA) are few. Thus, the authors aimed to construct a nomogram for predicting PLNM in curatively resected EJA.

METHODS

This study enrolled 638 EJA patients who received curative surgery resection and divided them randomly (7:3) into training and validation groups. For nomogram construction, 26 candidate parameters involving 21 preoperative clinical laboratory blood nutrition-related indicators, computed tomography (CT)-reported tumor size, CT-reported PLNM, gender, age, and body mass index were screened.

RESULTS

In the training group, Lasso regression included nine nutrition-related blood indicators in the PLNM-prediction nomogram. The PLNM prediction nomogram yielded an area under the receiver operating characteristic (ROC) curve of 0.741 (95 % confidence interval [CI], 0.697-0.781), which was better than that of the CT-reported PLNM (0.635; 95% CI 0.588-0.680; p < 0.0001). Application of the nomogram in the validation cohort still gave good discrimination (0.725 [95% CI 0.658-0.785] vs 0.634 [95% CI 0.563-0.700]; p = 0.0042). Good calibration and a net benefit were observed in both groups.

CONCLUSIONS

This study presented a nomogram incorporating preoperative nutrition-related blood indicators and CT imaging features that might be used as a convenient tool to facilitate the preoperative individualized prediction of PLNM for patients with curatively resected EJA.

Address: Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.; Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong Province, China.; Department of Oncological Laboratory Research, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.; Department of Gastrointestinal Endoscopy, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.; Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China. [email protected].; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong Province, China. [email protected].

DOI: 10.1245/s10434-023-13378-7

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https://dx.doi.org/10.1245/s10434-023-13378-7

MeSH Terms: Lymphatic Metastasis, Esophageal Neoplasms, Humans, Esophagogastric Junction, Adenocarcinoma, Nomograms, Tomography, X-Ray Computed