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25.06.2023 | Thoracic Oncology

Development and Validation of PET/CT-Based Nomogram for Preoperative Prediction of Lymph Node Status in Esophageal Squamous Cell Carcinoma

verfasst von: Shaoyuan Zhang, MD, Linyi Sun, MM, Danjie Cai, MD, Guobing Liu, MD, Dongxian Jiang, MD, Jun Yin, PhD, Yong Fang, MD, Hao Wang, MD, Yaxing Shen, MD, Yingyong Hou, MD, Hongcheng Shi, MD, Lijie Tan, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2023

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Abstract

Purpose

This study was conducted to predict the lymph node status and survival of esophageal squamous cell carcinoma before treatment by PET-CT-related parameters.

Methods

From January 2013 to July 2018, patients with pathologically diagnosed ESCC at our hospital were retrospectively enrolled. Completed esophagectomy and two- or three-field lymph node dissections were conducted. Those with neoadjuvant therapy were excluded. The first 65% of patients in each year were regarded as the training set and the last 35% as the test set. Nomogram was constructed by the “rms” package. Five-year, overall survival was analyzed based on the best cutoff value of risk score determined by the “survivalROC” package.

Results

Ultimately, 311 patients were included with 209 in the training set and 102 in the test set. The positive rate of the lymph node in the training set was 36.8% and that in the test set was 32.4%. The C-index of the training set was 0.763 and the test set was 0.766. The decision curve analysis showed that it was superior to the previous methods based on lymph node uptake or long/short axis diameter or axial ratio. Risk score > 0.20 was significantly associated with 5-year, overall survival (p = 0.0015) in all patients.

Conclusions

The nomogram constructed from PET-CT parameters including primary tumor metabolic length and thickness can accurately predict the risk of lymph node metastasis in ESCC. The risk score calculated by our model accurately predicts the patient’s 5-year overall survival.
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Literatur
1.
Zurück zum Zitat Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRefPubMed Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRefPubMed
2.
Zurück zum Zitat Xia C, Dong X, Li H, Cao M, Sun D, He S, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 2022;135(5):584–90.CrossRefPubMedPubMedCentral Xia C, Dong X, Li H, Cao M, Sun D, He S, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 2022;135(5):584–90.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Abnet CC, Arnold M, Wei W-Q. Epidemiology of esophageal squamous cell carcinoma. Gastroenterology. 2018;154(2):360–73.CrossRefPubMed Abnet CC, Arnold M, Wei W-Q. Epidemiology of esophageal squamous cell carcinoma. Gastroenterology. 2018;154(2):360–73.CrossRefPubMed
4.
Zurück zum Zitat Shapiro J, van Lanschot JJB, Hulshof MCCM, van Hagen P, van Berge Henegouwen MI, Wijnhoven BPL, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–8.CrossRefPubMed Shapiro J, van Lanschot JJB, Hulshof MCCM, van Hagen P, van Berge Henegouwen MI, Wijnhoven BPL, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–8.CrossRefPubMed
5.
Zurück zum Zitat Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, et al. Neoadjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial. J Clin Oncol. 2018;36(27):2796–803.CrossRefPubMedPubMedCentral Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, et al. Neoadjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial. J Clin Oncol. 2018;36(27):2796–803.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Leng X, He W, Yang H, Chen Y, Zhu C, Fang W, et al. Prognostic impact of postoperative lymph node metastases after neoadjuvant chemoradiotherapy for locally advanced squamous cell carcinoma of esophagus: from the results of NEOCRTEC5010, a randomized multicenter study. Ann Surg. 2021;274(6):e1022–9.CrossRefPubMed Leng X, He W, Yang H, Chen Y, Zhu C, Fang W, et al. Prognostic impact of postoperative lymph node metastases after neoadjuvant chemoradiotherapy for locally advanced squamous cell carcinoma of esophagus: from the results of NEOCRTEC5010, a randomized multicenter study. Ann Surg. 2021;274(6):e1022–9.CrossRefPubMed
7.
Zurück zum Zitat Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, et al. Long-term efficacy of neoadjuvant chemoradiotherapy plus surgery for the treatment of locally advanced esophageal squamous cell carcinoma: the NEOCRTEC5010 randomized clinical trial. JAMA Surg. 2021;156(8):721–9.CrossRefPubMedPubMedCentral Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, et al. Long-term efficacy of neoadjuvant chemoradiotherapy plus surgery for the treatment of locally advanced esophageal squamous cell carcinoma: the NEOCRTEC5010 randomized clinical trial. JAMA Surg. 2021;156(8):721–9.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Ishihara R, Mizusawa J, Kushima R, Matsuura N, Yano T, Kataoka T, et al. Assessment of the diagnostic performance of endoscopic ultrasonography after conventional endoscopy for the evaluation of esophageal squamous cell carcinoma invasion depth. JAMA Netw Open. 2021;4(9):e2125317.CrossRefPubMedPubMedCentral Ishihara R, Mizusawa J, Kushima R, Matsuura N, Yano T, Kataoka T, et al. Assessment of the diagnostic performance of endoscopic ultrasonography after conventional endoscopy for the evaluation of esophageal squamous cell carcinoma invasion depth. JAMA Netw Open. 2021;4(9):e2125317.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Japanese Classification of Esophageal Cancer. 11th Edition: part II and III. Esophagus. 2017;14(1):37–65.CrossRef Japanese Classification of Esophageal Cancer. 11th Edition: part II and III. Esophagus. 2017;14(1):37–65.CrossRef
10.
Zurück zum Zitat Lin D, Liu G, Jiang D, Yu Y, Wang H, Shi H, et al. The role of primary tumor SUVmax in the diagnosis of invasion depth: a step toward clinical T2N0 esophageal cancer. Ann Transl Med. 2021;9(2):112.CrossRefPubMedPubMedCentral Lin D, Liu G, Jiang D, Yu Y, Wang H, Shi H, et al. The role of primary tumor SUVmax in the diagnosis of invasion depth: a step toward clinical T2N0 esophageal cancer. Ann Transl Med. 2021;9(2):112.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Liu J, Wang Z, Shao H, Qu D, Liu J, Yao L. Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio. Eur Radiol. 2018;28(1):188–95.CrossRefPubMed Liu J, Wang Z, Shao H, Qu D, Liu J, Yao L. Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio. Eur Radiol. 2018;28(1):188–95.CrossRefPubMed
12.
Zurück zum Zitat Yoon YC, Lee KS, Shim YM, Kim B-T, Kim K, Kim TS. Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology. 2003;227(3):764–70.CrossRefPubMed Yoon YC, Lee KS, Shim YM, Kim B-T, Kim K, Kim TS. Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology. 2003;227(3):764–70.CrossRefPubMed
13.
Zurück zum Zitat Hong SJ, Kim TJ, Nam KB, Lee IS, Yang HC, Cho S, et al. New TNM staging system for esophageal cancer: what chest radiologists need to know. Radiographics. 2014;34(6):1722–40.CrossRefPubMed Hong SJ, Kim TJ, Nam KB, Lee IS, Yang HC, Cho S, et al. New TNM staging system for esophageal cancer: what chest radiologists need to know. Radiographics. 2014;34(6):1722–40.CrossRefPubMed
14.
Zurück zum Zitat Lee HN, Kim JI, Shin SY, Kim DH, Kim C, Hong IK. Combined CT texture analysis and nodal axial ratio for detection of nodal metastasis in esophageal cancer. Br J Radiol. 2020;93(1111):20190827.CrossRefPubMedPubMedCentral Lee HN, Kim JI, Shin SY, Kim DH, Kim C, Hong IK. Combined CT texture analysis and nodal axial ratio for detection of nodal metastasis in esophageal cancer. Br J Radiol. 2020;93(1111):20190827.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Liu C-J, Cheng JC-H, Lee J-M, Cheng M-F, Tzen K-Y, Yen R-F. Patterns of nodal metastases on 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma are useful to guide treatment planning of radiotherapy. Clin Nucl Med. 2015;40(5):384-9. Liu C-J, Cheng JC-H, Lee J-M, Cheng M-F, Tzen K-Y, Yen R-F. Patterns of nodal metastases on 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma are useful to guide treatment planning of radiotherapy. Clin Nucl Med. 2015;40(5):384-9.
16.
Zurück zum Zitat Xu M, Wang L, Ouyang M, Lin J, Wang L, Zheng X, et al. Prediction of lymph node metastasis by PET/CT metabolic parameters in patients with esophageal squamous cell carcinoma. Nucl Med Commun. 2019;40(9):933–9.CrossRefPubMed Xu M, Wang L, Ouyang M, Lin J, Wang L, Zheng X, et al. Prediction of lymph node metastasis by PET/CT metabolic parameters in patients with esophageal squamous cell carcinoma. Nucl Med Commun. 2019;40(9):933–9.CrossRefPubMed
17.
Zurück zum Zitat Yamada H, Hosokawa M, Itoh K, Takenouchi T, Kinoshita Y, Kikkawa T, et al. Diagnostic value of 18F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma. Surg Today. 2014;44(7):1258–65.CrossRefPubMed Yamada H, Hosokawa M, Itoh K, Takenouchi T, Kinoshita Y, Kikkawa T, et al. Diagnostic value of 18F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma. Surg Today. 2014;44(7):1258–65.CrossRefPubMed
18.
Zurück zum Zitat I HS, Kim S-J, Kim IJ, Kim K. Predictive value of metabolic tumor volume measured by 18F-FDG PET for regional lymph node status in patients with esophageal cancer. Clin Nucl Med. 2012;37(5):442-6. I HS, Kim S-J, Kim IJ, Kim K. Predictive value of metabolic tumor volume measured by 18F-FDG PET for regional lymph node status in patients with esophageal cancer. Clin Nucl Med. 2012;37(5):442-6.
19.
Zurück zum Zitat Moon SH, Kim HS, Hyun SH, Choi YS, Zo JI, Shim YM, et al. Prediction of occult lymph node metastasis by metabolic parameters in patients with clinically N0 esophageal squamous cell carcinoma. J Nucl Med. 2014;55(5):743–8.CrossRefPubMed Moon SH, Kim HS, Hyun SH, Choi YS, Zo JI, Shim YM, et al. Prediction of occult lymph node metastasis by metabolic parameters in patients with clinically N0 esophageal squamous cell carcinoma. J Nucl Med. 2014;55(5):743–8.CrossRefPubMed
20.
Zurück zum Zitat Tan X, Ma Z, Yan L, Ye W, Liu Z, Liang C. Radiomics nomogram outperforms size criteria in discriminating lymph node metastasis in resectable esophageal squamous cell carcinoma. Eur Radiol. 2019;29(1):392–400.CrossRefPubMed Tan X, Ma Z, Yan L, Ye W, Liu Z, Liang C. Radiomics nomogram outperforms size criteria in discriminating lymph node metastasis in resectable esophageal squamous cell carcinoma. Eur Radiol. 2019;29(1):392–400.CrossRefPubMed
21.
Zurück zum Zitat Ou J, Wu L, Li R, Wu C-Q, Liu J, Chen T-W, et al. CT radiomics features to predict lymph node metastasis in advanced esophageal squamous cell carcinoma and to discriminate between regional and non-regional lymph node metastasis: a case control study. Quant Imaging Med Surg. 2021;11(2):628–40.CrossRefPubMedPubMedCentral Ou J, Wu L, Li R, Wu C-Q, Liu J, Chen T-W, et al. CT radiomics features to predict lymph node metastasis in advanced esophageal squamous cell carcinoma and to discriminate between regional and non-regional lymph node metastasis: a case control study. Quant Imaging Med Surg. 2021;11(2):628–40.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Chen L, Ouyang Y, Liu S, Lin J, Chen C, Zheng C, et al. Radiomics analysis of lymph nodes with esophageal squamous cell carcinoma based on deep learning. J Oncol. 2022;2022:8534262.CrossRefPubMedPubMedCentral Chen L, Ouyang Y, Liu S, Lin J, Chen C, Zheng C, et al. Radiomics analysis of lymph nodes with esophageal squamous cell carcinoma based on deep learning. J Oncol. 2022;2022:8534262.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Xie C, Hu Y, Han L, Fu J, Vardhanabhuti V, Yang H. Prediction of individual lymph node metastatic status in esophageal squamous cell carcinoma using routine computed tomography imaging: comparison of size-based measurements and radiomics-based models. Ann Surg Oncol. 2022. Xie C, Hu Y, Han L, Fu J, Vardhanabhuti V, Yang H. Prediction of individual lymph node metastatic status in esophageal squamous cell carcinoma using routine computed tomography imaging: comparison of size-based measurements and radiomics-based models. Ann Surg Oncol. 2022.
24.
Zurück zum Zitat Zheng H, Tang H, Wang H, Fang Y, Shen Y, Feng M, et al. Nomogram to predict lymph node metastasis in patients with early oesophageal squamous cell carcinoma. Br J Surg. 2018;105(11):1464–70.CrossRefPubMed Zheng H, Tang H, Wang H, Fang Y, Shen Y, Feng M, et al. Nomogram to predict lymph node metastasis in patients with early oesophageal squamous cell carcinoma. Br J Surg. 2018;105(11):1464–70.CrossRefPubMed
25.
Zurück zum Zitat Li B, Chen H, Xiang J, Zhang Y, Kong Y, Garfield DH, et al. Prevalence of lymph node metastases in superficial esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg. 2013;146(5):1198–203.CrossRefPubMed Li B, Chen H, Xiang J, Zhang Y, Kong Y, Garfield DH, et al. Prevalence of lymph node metastases in superficial esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg. 2013;146(5):1198–203.CrossRefPubMed
Metadaten
Titel
Development and Validation of PET/CT-Based Nomogram for Preoperative Prediction of Lymph Node Status in Esophageal Squamous Cell Carcinoma
verfasst von
Shaoyuan Zhang, MD
Linyi Sun, MM
Danjie Cai, MD
Guobing Liu, MD
Dongxian Jiang, MD
Jun Yin, PhD
Yong Fang, MD
Hao Wang, MD
Yaxing Shen, MD
Yingyong Hou, MD
Hongcheng Shi, MD
Lijie Tan, MD
Publikationsdatum
25.06.2023
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2023
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13694-y

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