Abstract
BackgroundPreoperative radiotherapy tends to be more frequently used for patients with adenocarcinoma of the esophagogastric junction (AEG); however, the prognostic values of postoperative pathologic characteristics in these patients remain unclear. This study aimed to examine the outcomes in Siewert type II AEG patients receiving preoperative radiotherapy to identify the predictive factors for overall survival (OS).Methods and ResultsA total of 1818 AEG patients undergoing preoperative radiotherapy were reviewed. Univariate analyses showed that age, sex, histology, tumor grade, positive lymph node (PLN), lymph node ratio, and log odds of positive lymph nodes (LODDS) were significantly correlated with OS; however, only age, grade, PLN, and LODDS were identified as independent risk factors in a multivariate regression model. Subsequently, patients were randomly grouped into training and validation cohorts (1:1 ratio), and the beta coefficients of these variables in the training set were used to generate the nomogram. The composite nomogram showed improved prognostic accuracy in the training, validation, and entire cohorts compared with that of TNM stage alone.ConclusionsIn conclusion, our proposed nomogram represents a promising tool for estimating OS in Siewert type II AEG patients after preoperative radiotherapy.
Highlights
Preoperative radiotherapy tends to be more frequently used for patients with adenocarcinoma of the esophagogastric junction (AEG); the prognostic values of postoperative pathologic characteristics in these patients remain unclear
In the univariate analyses of clinicopathological variables as prognostic factors for overall survival (OS), age, sex, tumor grade, histology type, and all three lymph nodes (LNs)-related factors (PLN, LN ratio (LNR), and LODDS classifications) were significant risk factors for Siewert type II AEG patients after preoperative radiotherapy, whereas the ypT category did not correlate with OS (Table 1)
In multivariate analyses of all patients (Table 1), only age, tumor grade, positive lymph node (PLN) count, and LODDS value were significantly associated with OS
Summary
Preoperative radiotherapy tends to be more frequently used for patients with adenocarcinoma of the esophagogastric junction (AEG); the prognostic values of postoperative pathologic characteristics in these patients remain unclear. This study aimed to examine the outcomes in Siewert type II AEG patients receiving preoperative radiotherapy to identify the predictive factors for overall survival (OS). A total of 1818 AEG patients undergoing preoperative radiotherapy were reviewed. Univariate analyses showed that age, sex, histology, tumor grade, positive lymph node (PLN), lymph node ratio, and log odds of positive lymph nodes (LODDS) were significantly correlated with OS; only age, grade, PLN, and LODDS were identified as independent risk factors in a multivariate regression model.
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