Survival and prognostic factors in patients with synchronous multiple primary esophageal squamous cell carcinoma receiving deﬁnitive radiotherapy - A propensity score-matched analysis

Q: What was the study purpose regarding synchronous multiple primary ESCC?

To compare lesion characteristics and radiotherapy efficacy between single and synchronous multiple primary ESCC, evaluate the impact of multiple lesions, and build a nomogram survival prediction model for patients receiving definitive radiotherapy.

Q: How were patients selected and how were confounders handled?

The study enrolled 1,034 ESCC patients treated with definitive radiotherapy from 2010 to 2020. Efficacy was compared between 101 SMPESCC patients and 933 single-lesion patients, and propensity score matching was used to control potential confounders.

Q: Which factors independently predicted overall survival in SMPESCC?

In the SMPESCC group, Cox multivariate analysis identified T stage, chemotherapy, and lesion spacing as independent prognostic factors associated with overall survival.

Sep 24, 2026

Uploaded by Emma Wilson

Compares lesion characteristics and radiotherapy efficacy in patients with single versus synchronous multiple primary esophageal squamous cell carcinoma (SMPESCC), and quantifies how multiple lesions affect outcomes. A cohort of 1,034 esophageal squamous cell carcinoma patients receiving definitive radiotherapy (2010–2020) included 101 SMPESCC cases matched to 933 single-lesion cases using propensity score methods. Cox analyses identified multiple cancer as an independent adverse factor overall, while T stage, chemotherapy, and lesion spacing independently predicted SMPESCC survival. A Cox-based nomogram combining these factors showed good discrimination and calibration after internal validation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Purpose

Materials and methods

Study population and matching

Nomogram development

Results

Overall survival comparison

Prognostic factors

Model performance

Conclusions

TYPE Original Research PUBLISHED 24 March 2023 DOI 10.3389/fonc.2023.1132423 OPEN ACCESS EDITED BY Mingzhou Guo, People’s Liberation Army General Hospital, China REVIEWED BY Martin Leu, University Medical Center Göttingen, Germany Zhenzhou Yang, Chongqing Medical University, China *CORRESPONDENCE Guang Li [LG13804058616@163.com](LG13804058616@163.com) †These authors have contributed equally to this work SPECIALTY SECTION This article was submitted to Gastrointestinal Cancers: Gastric and Esophageal Cancers, a section of the journal Frontiers in Oncology RECEIVED 27 December 2022 ACCEPTED 13 March 2023 PUBLISHED 24 March 2023 CITATION Wang W, Liu X, Dang J and Li G (2023) Survival and prognostic factors in patients with synchronous multiple primary esophageal squamous cell carcinoma receiving deﬁnitive radiotherapy: A propensity score-matched analysis. Front. Oncol. 13:1132423 . doi: 10.3389/fonc.2023.1132423 COPYRIGHT © 2023 Wang, Liu, Dang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Survival and prognostic factors in patients with synchronous multiple primary esophageal squamous cell carcinoma receiving deﬁnitive radiotherapy: A propensity score-matched analysis Wenyi Wang 1†, Xiaoxu Liu 2†, Jun Dang 1 and Guang Li 1* 1 Department of Radiation Oncology, The First Afﬁliated Hospital of China Medical University, Shenyang, China, 2 Department of Surgical Oncology and General Surgery, The First Afﬁliated Hospital of China Medical University, Shenyang, China Purpose: To compare the lesion characteristics and radiotherapy efﬁcacy of patients with single and multiple esophageal squamous cell carcinoma (ESCC), to evaluate the effect of multiple lesions on ESCC, and establish a nomogram survival prediction model for patients with synchronous multiple primary esophageal squamous cell carcinoma (SMPESCC) who received deﬁnitive radiotherapy. Materials and methods:: The study enrolled 1,034 patients with ESCC who underwent deﬁnitive radiotherapy between 2010 and 2020 . The efﬁcacy of radiotherapy was compared between 101 patients with SMPESCC and 933 patients with single ESCC. Propensity score matching was used to control for potential confounders. For patients with SMPESCC, a nomogram prediction model was established based on the Cox regression model. Results: The median OS was 30 . 00 (95% CI = 25 .08-34. 92) months for the single lesion group and 19.00 (95% CI = 15.51-22.48) months for the multiple cancer group respectively. Multivariate COX regression analysis showed that multiple cancer was an independent prognostic factor for ESCC patients (HR=1.89, 95% CI=1 .49-2.38, P<0 . 001) . Cox multivariate analysis of SMPESCC patients showed that T stage (P =0.002), chemotherapy (P =0.006), and lesion spacing (P =0.004) were independent prognostic factors associated with OS. The nomogram was established by combining T stage, chemotherapy, and lesion spacing, and Harrell ’s C index was 0 .711 after internal cross-validation. The calibration curve and decision curve analysis conﬁrmed that the nomogram survival prediction model had a good predictive value for individual survival. Conclusions: The survival rate of single esophageal cancer is signiﬁcantly better than that of multiple lesions. Patients with SMPESCC exhibit worse survival than patients with single ESCC. Multiple lesions have a signiﬁcant impact on the Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) survival of patients with ESCC. The nomogram model established for SMPESCC patients can well predict th

FAQs

What was the study purpose regarding synchronous multiple primary ESCC?

To compare lesion characteristics and radiotherapy efficacy between single and synchronous multiple primary ESCC, evaluate the impact of multiple lesions, and build a nomogram survival prediction model for patients receiving definitive radiotherapy.

How were patients selected and how were confounders handled?

The study enrolled 1,034 ESCC patients treated with definitive radiotherapy from 2010 to 2020. Efficacy was compared between 101 SMPESCC patients and 933 single-lesion patients, and propensity score matching was used to control potential confounders.

Which factors independently predicted overall survival in SMPESCC?

In the SMPESCC group, Cox multivariate analysis identified T stage, chemotherapy, and lesion spacing as independent prognostic factors associated with overall survival.

Sep 24, 2026

Uploaded by Emma Wilson