{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:39:29Z","timestamp":1786117169451,"version":"build-2736575974"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Reliably predicting brain metastasis (BM) and brain metastasis\u2011free survival (BMFS) in patients with primary small cell carcinoma of the esophagus (PSCCE) remains a clinical challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To develop and externally validate predictive nomograms for assessing BM probability and BMFS in patients with PSCCE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective model development and external validation study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using a training cohort, we constructed two separate nomograms. The first was developed using univariable and multivariable logistic regression to predict the probability of BM. The second was built using a Fine\u2011Gray competing-risk model to estimate BMFS, treating death without BM as a competing event. The performance of both nomograms was evaluated using the area under the receiver operating characteristic (ROC) curve\/time-dependent ROC curve, calibration plots, and decision curve analysis (DCA). External validation was subsequently performed using an independent validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study sample included 492 patients in the training cohort (mean age at diagnosis 61.97\u2009\u00b1\u20098.86\u2009years; 133 (27%) female) and 344 patients in the external validation cohort (mean age at diagnosis 62.97\u2009\u00b1\u20098.14\u2009years; 108 (31%) female). Age, N stage, and M stage emerged as independent predictors and were included in a nomogram to estimate BM risk. Adding lesion length and initial treatments (radiotherapy, chemotherapy, and surgery) to these three factors allowed the model to predict BMFS. Both nomograms showed strong predictive performance in the training cohort, with area under the ROC curve values of 0.76 and 0.843, respectively, supported by calibration plots and DCA. These results were confirmed in the external validation cohort. The logistic regression\u2011based nomogram accurately predicted BM probability, while the Fine\u2013Gray model provided reliable estimates of BMFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We successfully developed and externally validated two complementary nomograms that reliably predict BM probability and BMFS in patients with PSCCE. These tools may aid in risk stratification and inform personalized surveillance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261469564","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:33:07Z","timestamp":1785843187000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and external validation of two nomograms for predicting brain metastases and brain metastasis-free survival in primary small cell carcinoma of the esophagus: a retrospective multicenter analysis"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8688-5847","authenticated-orcid":false,"given":"Liang","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8544-9007","authenticated-orcid":false,"given":"Qifeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingwu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihui","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Anyang Cancer Hospital, The Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Yang","sequence":"additional","affiliation":[{"name":"Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujun","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Oncology, Affiliated Hospital of Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Binzhou Medical University Hospital, Binzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wencheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin 300060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin 300060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3191-2272","authenticated-orcid":false,"given":"Meng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin\u2019s Clinical Research Center for Cancer, Tianjin Lung Cancer Center, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin 300060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2024.01.006"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-199104000-00004"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.09.1966"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0000000000000546"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.09.075"},{"key":"e_1_3_4_7_2","first-page":"1","article-title":"Treatment and survival outcomes of small cell carcinoma of the esophagus: an analysis of the National Cancer Data Base","volume":"30","author":"Wong AT","year":"2017","unstructured":"Wong AT, Shao M, Rineer J, et al. Treatment and survival outcomes of small cell carcinoma of the esophagus: an analysis of the National Cancer Data Base. Dis Esophagus 2017; 30: 1\u20135.","journal-title":"Dis Esophagus"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2015.3.11368"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2008.00863.x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073274821989321"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm476"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000115)88:2<262::AID-CNCR3>3.0.CO;2-K"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2022.1393"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v10.i22.3345"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908123410703"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071780"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-078378"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19891001)64:7<1531::AID-CNCR2820640729>3.0.CO;2-0"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19971015)80:8<1366::AID-CNCR2>3.0.CO;2-D"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.107.1.179"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(95)70390-X"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4829"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-4475-3"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji128"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000025427"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.JCRT_1612_20"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i30.9011"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35281"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12230"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1415-9"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31829f6b03"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2010.01133.x"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12069"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/jne.13306"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2022.09.008"}],"container-title":["Therapeutic Advances in Medical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359261469564","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17588359261469564","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359261469564","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:19:07Z","timestamp":1786022347000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17588359261469564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":35,"alternative-id":["10.1177\/17588359261469564"],"URL":"https:\/\/doi.org\/10.1177\/17588359261469564","relation":{},"ISSN":["1758-8359","1758-8359"],"issn-type":[{"value":"1758-8359","type":"print"},{"value":"1758-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"17588359261469564"}}