A nomogram for predicting individual survival of patients with gastric cancer who underwent radical surgery with extended lymph node dissection
A nomogram for predicting individual survival of patients with gastric cancer who underwent radical surgery with extended lymph node dissection
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DOI：
10.1007/s10120-013-0270-x
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发表时间：
2014-04-01
期刊：
影响因子：
7.4
通讯作者：
Park, Cho Hyun
中科院分区：
文献类型：
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作者：
Song, Kyo Young;Park, Yong Gyu;Park, Cho Hyun
我们开发并验证了一个诺模图，用于一个高容量中心，其中根治性手术和扩大淋巴结清扫术是胃癌的标准治疗方法。总体而言，1,614例患者被随机分为测试集（n = 805）和验证集（n = 809）。采用考克斯比例风险回归模型计算评分系统，以胃癌生存期作为预测终点。使用一致性指数（c指数）作为准确性指标，使用自举法校正乐观偏倚。根据考克斯模型，我们建立了一个诺模图，预测从手术开始的3年和5年生存率。在测试集和验证集中，自举校正的c指数分别为0.87和0.84。两组患者的生存率预测良好。我们的诺模图的预测比AJCC分期系统更好地区分（测试集：c指数，0.87对0.77; P < 0.0001;验证集：c指数，0.84对0.79; P < 0.001），但不影响正常工作。我们开发并验证了一种列线图，该列线图可显著准确地预测接受根治性胃切除术的韩国胃癌患者的术后生存率。进行淋巴结清扫
We developed and validated a nomogram for use at a high-volume center where radical surgery with extended lymph node dissection is the standard treatment for gastric cancer.Overall, 1,614 patients were randomly divided into the test set (n = 805) and validation set (n = 809). The scoring system was calculated using a Cox proportional hazard regression model with the survival of gastric cancer as the predicted endpoint. The concordance index (c-index) was used as an accuracy measure, with bootstrapping to correct for optimistic bias. Calibration plots were constructed.Based on a Cox model, we developed a nomogram that predicts the probability of 3- and 5-year survival from the time of surgery. The bootstrap-corrected c-indices were 0.87 and 0.84 in the test and validation sets, respectively. Survival was well predicted in both sets. The predictions of our nomogram discriminated better than the AJCC staging system (test set: c-index, 0.87 vs. 0.77; P < 0.0001; validation set: c-index, 0.84 vs. 0.79; P < 0.001).We developed and validated a nomogram that provided a significantly accurate prediction of postoperative survival in Korean patients with gastric cancer who underwent radical gastrectomy with extended lymph node dissection.