Abstract
Background and Aim: Primary small cell carcinoma of the esophagus (SCCE) is a rarely aggressive disease characterized by rapid progression, widespread metastasis, and poor prognosis. This study was aimed to evaluate the prognostic significance of serum lipids for overall survival (OS) in SCCE patients.Methods: We retrospectively analyzed SCCE patients in a training cohort (61 patients) and validated them in a validation cohort (27 patients). These cases were collected from Sun Yat-sen University Cancer Center from 2006 to 2017. Univariate and multivariate Cox survival analyses were performed to determine serum lipids as prognostic factors associated with the patient's OS. Time-dependent receiver operating characteristics (ROC) were used to compare predictive power of independent prognostic factors. The predictive accuracy and discriminative ability of the prognostic factors were measured by the concordance index (C-index) and decision curve, and were compared with the TNM stage system.Results: On multivariate analysis of the training cohort, independent factors for survival were gender, BAR (ApoB/ApoA-1) and TNM stage. The area under the curve (AUC) of BAR+TNM stage in the training cohort was higher than that of TNM stage for OS, and similar result was observed in the validation cohort. The c-index of BAR+TNM stage for predicting the OS was 0.655 (95% CI = 0.571–0.740), which was higher than that of TNM stage [0.614 (95% CI = 0.530–0.698)] in the training cohort. In the validation cohort, the C-index of the BAR+TNM stage for predicting OS was also higher than that of the TNM stage [0.688 (95% CI: 0.570~0.806) vs. (0.512; 95% CI: 0.392~0.632)]. In addition, decision curve analysis also showed that the predictive accuracy of BAR+TNM stage for OS was higher than TNM stage both in the training and the validation cohorts.Conclusions: BAR represents a promising prognostic indicator that might complement TNM stage in the prognosis of SCCE, and that warrant further assessment in large SCCE patient cohort.
Highlights
Esophageal cancer is one of the most common malignant tumors in China, and its histological type is most common in squamous cell carcinoma [1]
The area under the curve (AUC) of ApoB/ApoA1 ratios (BAR)+TNM stage in the training cohort was higher than that of TNM stage for overall survival (OS), and similar result was observed in the validation cohort
The c-index of BAR+TNM stage for predicting the OS was 0.655, which was higher than that of TNM stage [0.614] in the training cohort
Summary
Esophageal cancer is one of the most common malignant tumors in China, and its histological type is most common in squamous cell carcinoma [1]. Primary small cell carcinoma of the esophagus (SCCE) is a relatively rare histopathological type, accounting for only 0.8–3.1% of all malignant tumors of the esophagus [2, 3]. As a high incidence country of esophageal cancer, increasing studies were focused on SCCE in China [1, 6]. SCCE is a highly aggressive disease characterized by rapid progression, extensive metastasis and poor prognosis, with a higher incidence of males than females [7,8,9,10]. Primary small cell carcinoma of the esophagus (SCCE) is a rarely aggressive disease characterized by rapid progression, widespread metastasis, and poor prognosis. This study was aimed to evaluate the prognostic significance of serum lipids for overall survival (OS) in SCCE patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
