AUTHOR=Hu Jing Feng , Song Xin , Zhong Kan , Zhao Xue Ke , Zhou Fu You , Xu Rui Hua , Li Ji Lin , Wang Xian Zeng , Li Xue Min , Wang Pan Pan , Lei Ling Ling , Wei Meng Xia , Wang Ran , Fan Zong Min , Han Xue Na , Chen Yao , Li Liu Yu , Ji Jia Jia , Yang Yuan Ze , Li Bei , Yang Miao Miao , Yang Hai Jun , Chang Fu Bao , Ren Jing Li , Zhou Sheng Li , Wang Li Dong TITLE=Increases prognostic value of clinical-pathological nomogram in patients with esophageal squamous cell carcinoma JOURNAL=Frontiers in Oncology VOLUME=13 YEAR=2023 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.997776 DOI=10.3389/fonc.2023.997776 ISSN=2234-943X ABSTRACT=Background

This study was intended to construct a brand new prognostic nomogram after combine clinical and pathological characteristics to increases prognostic value in patients with esophageal squamous cell carcinoma.

Methods

A total of 1,634 patients were included. Subsequently, the tumor tissues of all patients were prepared into tissue microarrays. AIPATHWELL software was employed to explore tissue microarrays and calculate the tumor-stroma ratio. X-tile was adopted to find the optimal cut-off value. Univariate and multivariate Cox analyses were used to screen out remarkable characteristics for constructing the nomogram in the total populations. A novel prognostic nomogram with clinical and pathological characteristics was constructed on the basis of the training cohort (n=1,144). What’s more performance was validated in the validation cohort (n=490). Clinical-pathological nomogram were assessed by concordance index, time-dependent receiver operating characteristic, calibration curve and decision curve analysis.

Results

The patients can divide into two groups with cut-off value of 69.78 for the tumor-stroma ratio. It is noteworthy that the survival difference was noticeable (P<0.001). A clinical-pathological nomogram was constructed by combining clinical and pathological characteristics to predict the overall survival. In comparison with TNM stage, the concordance index and time-dependent receiver operating characteristic of the clinical-pathological nomogram showed better predictive value (P<0.001). High quality of calibration plots in overall survival was noticed. As demonstrated by the decision curve analysis, the nomogram has better value than the TNM stage.

Conclusions

As evidently revealed by the research findings, tumor-stroma ratio is an independent prognostic factor in patients with esophageal squamous cell carcinoma. The clinical-pathological nomogram has an incremental value compared TNM stage in predicting overall survival.