Systematic review and validation of clinical models predicting survival after oesophagectomy for adenocarcinoma
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Published version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Oesophageal adenocarcinoma poses a significant global health burden, yet the staging used to predict survival has limited ability to stratify patients by outcome. This study aimed to identify published clinical models that predict survival in oesophageal adenocarcinoma and to evaluate them using an independent international multicentre dataset. METHODS: A systematic literature search (title and abstract) using the Ovid Embase and MEDLINE databases (from 1947 to 11 July 2020) was performed. Inclusion criteria were studies that developed or validated a clinical prognostication model to predict either overall or disease-specific survival in patients with oesophageal adenocarcinoma undergoing surgical treatment with curative intent. Published models were validated using an independent dataset of 2450 patients who underwent oesophagectomy for oesophageal adenocarcinoma with curative intent. RESULTS: Seventeen articles were eligible for inclusion in the study. Eleven models were suitable for testing in the independent validation dataset and nine of these were able to stratify patients successfully into groups with significantly different survival outcomes. Area under the receiver operating characteristic curves for individual survival prediction models ranged from 0.658 to 0.705, suggesting poor-to-fair accuracy. CONCLUSION: This study highlights the need to concentrate on robust methodologies and improved, independent, validation, to increase the likelihood of clinical adoption of survival predictions models.
Date Issued
2022-05
Date Acceptance
2022-01-10
Citation
British Journal of Surgery, 2022, 109 (5), pp.418-425
ISSN
0007-1323
Publisher
British Journal of Surgery Society
Start Page
418
End Page
425
Journal / Book Title
British Journal of Surgery
Volume
109
Issue
5
Copyright Statement
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which
permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which
permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Royal College Of Surgeons Of England
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35233634
PII: 6540610
Grant Number
WSSS_P67655
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
PROGNOSTIC SCORING SYSTEM
NEOADJUVANT CHEMORADIOTHERAPY
CANCER
NOMOGRAM
ESOPHAGUS
BENEFIT
CHEMORADIATION
RESECTION
JUNCTION
SURGERY
POEM Biomarkers Consortium and OCCAMS Consortium
Surgery
11 Medical and Health Sciences
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2022-03-02