Nomogram to Predict Treatment Outcome of Fluoropyrimidine/Platinum-Based Chemotherapy in Metastatic Esophageal Squamous Cell Carcinoma.
- Author:
Hyun Ae JUNG
1
;
Antoine ADENIS
;
Jeeyun LEE
;
Se Hoon PARK
;
Chi Hoon MAENG
;
Silvia PARK
;
Hee Kyung AHN
;
Young Mog SHIM
;
Nicolas PENEL
;
Young Hyuck IM
Author Information
1. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jyunlee@skku.edu
- Publication Type:Original Article
- Keywords:
Esophageal squamous cell carcinoma;
Prognostic factor;
Nomograms
- MeSH:
Carcinoma, Squamous Cell*;
Cohort Studies;
Dataset;
Disease-Free Survival;
Drug Therapy*;
Esophagectomy;
Humans;
Multivariate Analysis;
Nomograms*;
Treatment Outcome*;
Weight Loss
- From:Cancer Research and Treatment
2013;45(4):285-294
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The degree of benefit from palliative chemotherapy differs widely among patients with metastatic esophageal squamous cell carcinoma (MESCC). The purpose of this study was to develop and validate a prognostic nomogram to predict survival and aid physicians and patients in the decision-making process regarding treatment options. MATERIALS AND METHODS: Clinicopathologic variables and treatment outcomes of 239 patients who were diagnosed with MESCC and received either fluorouracil/cisplatin (FP) or capecitabine/cisplatin (XP) as first-line chemotherapy were reviewed. A nomogram was developed as a prognostic scoring system incorporating significant clinical and laboratory variables based on a multivariate Cox proportional hazards regression model. An independent series of 61 MESCC patients treated with FP served as an independent data set for nomogram validation. RESULTS: No difference in response rate was observed between the FP group (44.8%) and the XP group (54.2%). Similarly, no significant differences in median progression-free survival and median overall survival were observed between regimen groups. Multivariate analysis showed that poor performance status (Eastern Cooperative Oncology Group [ECOG] status> or =2), weight loss (10% of the weight loss for 3 months), low albumin level (< or =3.5 g/dL), and absence of previous esophagectomy at the time of chemotherapy were significantly associated with low OS in both groups (p<0.05). Based on these findings, patients were classified into favorable (score, 0 to 90), intermediate (91-134), and poor (>135) prognostic groups. The median survival for those with a favorable ECOG was 13.8 months (95% confidence interval [CI], 10.8 to 18.6 months), for intermediate 11.2 months (95% CI, 8.7 to 11.9 months), and for poor, 7.0 months (95% CI, 3.6 to 10.0 months). External validation of the nomogram in a different patient cohort yielded significantly similar findings. CONCLUSION: The nomogram described here predicts survival in MESCC patients and could serve as a guide for the use of FP/XP chemotherapy in MESCC patients.
