Prognostic and incremental value of computed tomography-based radiomics from tumor and nodal regions in esophageal squamous cell carcinoma

IF 7 2区医学 Q1 ONCOLOGY

Chinese Journal of Cancer Research Pub Date : 2022-04-30 DOI:10.21147/j.issn.1000-9604.2022.02.02

B. Cao, Kun Mi, W. Dai, Tong Liu, T. Xie, Qiang Li, J. Lang, Yongtao Han, Lin Peng, Qifeng Wang

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引用次数: 3

Abstract

Objective This study aimed to evaluate the prognostic value of preoperative radiomics and establish an integrated model for esophageal squamous cell cancer (ESCC). Methods A total of 931 patients were retrospectively enrolled in this study (training cohort, n=624; validation cohort, n=307). Radiomics features were obtained by contrast-enhanced computed tomography (CT) before esophagectomy. A radiomics index was set based on features of tumor and reginal lymph nodes by using the least absolute shrinkage and selection operator (LASSO) Cox regression. Prognostic nomogram was built based on radiomics index and other independent risk factors. The prognostic value was assessed by using Harrell’s concordance index, time-dependent receiver operating characteristics and Kaplan-Meier curves. Results Twelve radiomic features from tumor and lymph node regions were identified to build a radiomics index, which was significantly associated with overall survival (OS) in both training cohort and validation cohort. The radiomics index was highly correlated with clinical tumor-node-metastasis (cTNM) and pathologic TNM (pTNM) stages, but it demonstrated a better prognostic value compared with cTNM stage and was almost comparable with pTNM stage. Multivariable Cox regression showed that the radiomics index was an independent prognostic factor. An integrated model was constructed based on gender, preoperative serum sodium concentration, pTNM and the radiomics index for clinical usefulness. The integrated model demonstrated discriminatory ability better compared with the traditional clinical-pathologic model and pTNM alone, indicating incremental value for prognosis. Conclusions CT-based radiomics for primary tumor and reginal lymph nodes was sufficient in predicting OS for patients with ESCC. The integrated model demonstrated incremental value for prognosis and was robust for clinical applications.

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基于计算机断层扫描的食管鳞状细胞癌肿瘤和淋巴结区域放射组学的预后和增量价值

目的评价术前放射组学对癌症食管鳞状细胞癌（ESCC）预后的价值，建立食管鳞状细胞瘤综合模型。方法共有931名患者被回顾性纳入本研究（训练队列，n=624；验证队列，n=307）。在食管切除术前通过对比增强计算机断层扫描（CT）获得放射组学特征。基于肿瘤和区域淋巴结的特征，使用最小绝对收缩和选择算子（LASSO）Cox回归设置放射组学指数。根据放射组学指数和其他独立的危险因素建立预后列线图。采用Harrell一致性指数、时间依赖性受试者操作特征和Kaplan-Meier曲线评估预后价值。结果确定了来自肿瘤和淋巴结区域的12个放射组学特征，以建立放射组学指数，该指数与训练队列和验证队列的总生存率（OS）显著相关。放射组学指标与临床肿瘤淋巴结转移（cTNM）和病理TNM（pTNM）分期高度相关，但与cTNM分期相比具有更好的预后价值，几乎与pTNM分期相当。多变量Cox回归显示放射组学指数是一个独立的预后因素。基于性别、术前血清钠浓度、pTNM和放射组学指数构建了一个综合模型，用于临床应用。与传统的临床病理模型和单独的pTNM相比，整合模型表现出更好的辨别能力，表明其对预后的价值增加。结论基于CT的原发肿瘤和区域淋巴结放射组学足以预测ESCC患者的OS。该综合模型显示了对预后的增量价值，并且在临床应用中是稳健的。

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来源期刊

Chinese Journal of Cancer Research 医学-肿瘤学

自引率

9.80%

发文量

1726

审稿时长

4.5 months

期刊介绍： Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.