1-year recurrence-free survival after trimodality therapy for esophageal adenocarcinoma.
Estimates early recurrence risk at one year following trimodality therapy for patients diagnosed with esophageal adenocarcinoma. 
Research authors: Lucas Goense, Peter S.N. van Rossum, Mian Xi, Dipen M. Maru, Brett W. Carter, Gert J. Meijer, Linus Ho, Richard van Hillegersberg, Wayne L. Hofstetter, Steven H. Lin
Details Formula Study characteristics Files & References
★★★
Model author
Model ID
1235
Version
1.7
Revision date
2018-12-28
Specialty
MeSH terms
  • Gastrointestinal Cancer
  • Esophageal Cancer
  • Adenocarcinoma
  • Esophagectomy
  • Chemoradiotherapy
  • Nomogram
  • Model type
    R-Script model (Calculation)
    Status
    public
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    Formula
    No Formula defined yet
    Condition Formula

    Additional information

    In total, 568 consecutive patients with potentially resectable esophageal adenocarcinoma who underwent CRT were included for analysis, including 373 patients who underwent esophagectomy after CRT (trimodality therapy), and 195 who did not undergo surgery (bimodality therapy). A nomogram for 1-year RFS was created using a Cox regression model. The upper tertile of the nomogram score was used to stratify patients in low-risk and high-risk groups for 1-year recurrence.

    Data shown concerns the group of patients receiving trimodality therapy. 

    Study Population

    Total population size: 373
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 60 10 Year
    BMI 25.9 5.04 kg/m2
    Days from completion CRT to surgery 60 19 Days

    Categorical characteristics

    Name Subset / Group Nr. of patients
    ECOG performance status 0 160
    1-2 213
    Weight loss <10% 294
    10%+ 79
    Histologic grade Good/moderate 164
    Poor 209
    Signet ring cell adenocarcinoma No 317
    Yes 56
    EUS-based tumor length (cm) <4 150
    4+ 223
    Nontraversability by EUS No 310
    Yes 63
    Clinical T status (7th) IB/II 47
    III/IVa 326
    Clinical N status (7th) cN0 133
    cN1 138
    cN2-3 102
    Maximum lymph node diameter (cm) <1 259
    1+ 114
    PET avid nodes at baseline mN0 225
    mN+ 148
    Celiac lymph node involvement No 354
    Yes 19
    Induction chemotherapy No 235
    Yes 138
    Chemotherapy regimen Oxaliplatin/5-FU 150
    Docetaxel/5-FU 104
    Docetaxel/capecitabine 81
    Other 38
    Total radiation dose (Gy) 45.0 17
    50.4 356
    Subjective assessment 18F-FDG PET No complete response 251
    Clinical complete response 122
    Postchemoradiation endoscopic biopsy No residual cancer 319
    Residual cancer 49

    Related files

    Probability of 1-year recurrence free survival is:
    ...
    %

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    Result
    Note
    Notes are only visible in the result download and will not be saved by Evidencio

    Probability of 1-year recurrence free survival is: %

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    Outcome stratification

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    Conditional information

    Result interpretation

    The current model predicts the preoperative probability of early disease recurrence after trimodality therapy for patients with esophageal cancer. The addition of surgery to chemoradiotherapy provided a clear overall survival benefit in patients at low risk of early disease recurrence. The overall survival benefit of surgery in high-risk patients was less pronounced.

    External validation and improvement of the model with new imaging or biomarkers is desired. 

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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