ArticleFrontiers in oncology2026
Construction and verification of 5-year survival prediction model for post-op ESCC patients.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To develop a predictive model for the 5-year postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC), and to provide a basis for the accurate assessment of clinical prognosis. Methods: A total of 260 ESCC patients who underwent surgery between January 2017 and June 2019 were included and randomly divided into a training set (n=182) and a validation set (n=78) at a 7:3 ratio. Univariate and multivariate Cox proportional hazards regression analyses were performed in the training set to identify independent predictors of 5-year overall survival (OS). A nomogram was constructed based on the selected factors. The model's performance was evaluated using the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Results: The 5-year OS rate in the training set was 63.7% (116/182). Multivariate Cox regression identified five independent predictors of 5-year OS: American Joint Committee on Cancer stage (HR = 1.347, 95% CI: 1.209-1.510), lymph node metastasis (HR = 4.698, 95% CI: 3.282-8.994), tumor differentiation grade (HR = 1.235, 95% CI: 1.105-1.276), microvessel density (HR = 1.089, 95% CI: 1.023-1.159), and Vascular Endothelial Growth Factor (VEGF) expression (HR = 2.451, 95% CI: 1.127-6.372). The nomogram demonstrated good discrimination, with C-index values of 0.886 (training set) and 0.845 (validation set). The areas under the ROC curves were 0.889 (95% CI: 0.822-0.955) and 0.844 (95% CI: 0.695-0.992), respectively. Calibration curves and DCA indicated satisfactory agreement and clinical net benefit across a wide threshold probability range. Conclusion: The nomogram integrating clinicopathological and molecular factors effectively predicts 5-year OS in ESCC patients after surgery, offering a reliable visual tool for individualized risk stratification and clinical decision-making.
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