A novel risk score system for prognostic evaluation in adenocarcinoma of the oesophagogastric junction: a large population study from the SEER database and our center

BMC Cancer. 2021 Jul 13;21(1):806. doi: 10.1186/s12885-021-08558-1.

Abstract

Background: The incidence rate of adenocarcinoma of the oesophagogastric junction (AEG) has significantly increased over the past decades, with a steady increase in morbidity. The aim of this study was to explore a variety of clinical factors to judge the survival outcomes of AEG patients.

Methods: We first obtained the clinical data of AEG patients from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and least absolute shrinkage and selection operator (LASSO) regression models were used to build a risk score system. Patient survival was analysed using the Kaplan-Meier method and the log-rank test. The specificity and sensitivity of the risk score were determined by receiver operating characteristic (ROC) curves. Finally, the internal validation set from the SEER database and external validation sets from our center were used to validate the prognostic power of this model.

Results: We identified a risk score system consisting of six clinical features that can be a good predictor of AEG patient survival. Patients with high risk scores had a significantly worse prognosis than those with low risk scores (log-rank test, P-value < 0.0001). Furthermore, the areas under ROC for 3-year and 5-year survival were 0.74 and 0.75, respectively. We also found that the benefits of chemotherapy and radiotherapy were limited to stage III/IV AEG patients in the high-risk group. Using the validation sets, our novel risk score system was proven to have strong prognostic value for AEG patients.

Conclusions: Our results may provide new insights into the prognostic evaluation of AEG.

Keywords: Adenocarcinoma of the oesophagogastric junction; External validation; LASSO method; Prognostic evaluation; SEER.

MeSH terms

  • Adenocarcinoma / mortality*
  • Adenocarcinoma / pathology
  • Aged
  • Databases, Factual / standards*
  • Esophagogastric Junction / pathology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Risk Factors
  • SEER Program / standards*