Prognostic factors of disease-free survival in type Ⅱ and Ⅲ esophagogastric junction adenocarcinoma patients and construction of a nomogram model

Acta Universitatis Medicinalis Anhui 2025 01 v.60 159-166     font:big middle small

Found programs: Research Project of Anhui Provincial Institute of Translational Medicine (No. 2022zhyx-C88);National and Provincial Key Specialty Construction Plan (No. Z155080000004);Anhui Public Health Clinical Center,Scientific Research and Cultivation Foundation of The First Affiliated Hospital (North District) of Anhui Medical University (No. 2024YKJ11)

Authors:Luo Panquan; Xiao Nanping; Guo Tao; Zhang Herui; Peng Shihao

Keywords:esophagogastric junction adenocarcinoma;disease-free survival;hepatitis B;prognosis;TNM stage;nomogram

DOI:10.19405/j.cnki.issn1000-1492.2025.01.023

〔Abstract〕 Objective To investigate the independent prognostic factors affecting disease-free survival(DFS) after radical surgery in Ⅱ and Ⅲ adenocarcinoma of gastroesophageal junction(AEG) patients, and to construct a nomogram prediction model. Methods A retrospective analysis was conducted on a cohort comprising 326 patients who were diagnosed with AEG. Chi-square test was used for categorical variable analysis. The survival analysis was drawn by Kaplan-Meier method and tested by log-rank method. Univariate and multivariate Cox regression analyses identified independent prognostic factors, and based on these factors, a nomogram was constructed to predict 3-year and 5-year DFS in AEG patients. The calibration curves evaluated the performance of nomogram. Results Among 326 AEG patients, 281 were in the young group(<70 years old) and 45 were in the old group(≥70 years old). Kaplan-Meier curve showed that patients with advanced age, TNM stage Ⅰ-Ⅱ and no history of hepatitis B had longer DFS. Univariate and multivariate analysis showed that age, TNM stage and history of hepatitis B were independent prognostic factors for DFS. The 3-year and 5-year correction curves showed that the prediction efficiency of nomogram was good. The decision curve analysis showed that the model had a good clinical net benefit. Conclusion Age, TNM stage and history of hepatitis B are independent prognostic factors for DFS in AEG patients. The nomogram constructed and validated can be used to predict DFS in AEG patients.