title: Prognostic scoring system predictive of survival after surgical resection of esophageal carcinoma.
abstract: BACKGROUND
  The aim of our study was to develop a prognostic index score for patients undergoing surgical resection for esophageal cancer that accurately determines survival with specific clinicopathological characteristics.
  
  
  METHODS
  Clinical, histological, and demographical variables of 475 patients were entered in an univariate and multivariate regression model, followed by individual calculation of the Prognostic Indicator Score and model validation via simulation.
  
  
  RESULTS
  Significant variables included in the scoring system were number of positive lymph nodes, pT, pL, R, obesity, and American Society of Anesthesiologist classification. Survival probability and its associated hazard function was significantly different between the scores, with an increase of hazard ratio ranging from 2.56 (score 2) to 20 (score 6 or higher). Comparing histological cancer entities revealed statistical significance only between stage IIA versus IIB in squamous cell and stage IIIA versus IIIB in adenocarcinoma.
  
  
  CONCLUSIONS
  According to our methodology, an individualized follow-up by each possible score might allow interdisciplinary selection of patients for treatments based on expected survival. This may represent a breakthrough in patient selection for currently available treatments and clinical studies.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center of Mainz, Germany, Mainz, Germany.
authors.forename: Ines
authors.initials: I
authors.lastname: Gockel
authors.forename: Stefan
authors.initials: S
authors.lastname: Niebisch
authors.forename: Lynetta K
authors.initials: LK
authors.lastname: Campbell
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.forename: Theodor
authors.initials: T
authors.lastname: Junginger
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003198:Computer Simulation; D003661:Decision Support Techniques; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome