Prognosis of elderly gastric cancer patients after surgery: a nomogram to predict survival
Prognosis of elderly gastric cancer patients after surgery: a nomogram to predict survival
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DOI：
10.1007/s12032-018-1166-8
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发表时间：
2018-07-01
期刊：
影响因子：
3.4
通讯作者：
Marchetti, Paolo
中科院分区：
文献类型：
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作者：
Roberto, Michela;Botticelli, Andrea;Marchetti, Paolo
本研究旨在探讨影响老年胃癌（GC）预后的临床病理因素，并构建个体风险预测的nomogram。收集143例年龄80岁的胃癌手术患者的肿瘤特征，采用单因素和多因素分析。使用与总生存显著相关的因素构建预后nomogram。采用Kaplan-Meier （KM）曲线和箱线图检验nomogram辨别力。中位随访18.37个月，总1年生存率为51%，年龄大于83岁者为60%，年龄小于83岁者为40% （P = 0.003）。单因素分析显示，年龄（P = 0.008）、术前工作状态（P < 0.001）、浸润深度（P = 0.007）、淋巴结累及（P < 0.001）、肿瘤残留（P < 0.001）是影响预后的重要因素。基于这些变量，我们建立了预测胃癌术后3、6、12和24个月生存率的nomogram。KM和箱线图根据nomogram total point的范围突出了区分各亚组患者生存率的适宜性。此外，与AJCC-TNM分类相比，该nomogram在中期（II-III）之间表现出更好的预后辨别能力。本研究表明，在良好的手术选择后，老年胃癌患者的预后可能受到多种临床病理因素的影响。因此，预测nomogram nomogram nomogram预测nomogram nomogram nomogram预测nomogram nomogram nomogram预测nomogram nomogram nomogram预测nomogram nomogram nomogram预测nomogram nomogram（拟合型）因此，预测nomogram（拟合型）可能使医生能够个性化治疗，并发现那些可能受益于多学科综合治疗的患者。
This study aimed to identify clinicopathological factors associated with the outcome of elderly patients with gastric cancer (GC), and to construct a nomogram for individual risk prediction. Tumor characteristics of 143 patients aged ae 80 years underwent surgery for GC were collected and analyzed by uni- and multivariate analyses. A prognostic nomogram was constructed using the factors which resulted to be significantly associated with overall survival. Discrimination of nomogram was tested by Kaplan-Meier (KM) curves and boxplots. With a median follow up of 18.37 months, overall 1-year survival rate was 51% and it was 60 and 40% for older and younger than 83 years, respectively (P = 0.003). Univariate analysis indicated that age (P = 0.008), pre-operatory performance status (P < 0.001), depth of invasion (P = 0.007), lymph nodes involvement (P < 0.001), and residual tumor (P < 0.001) were significant prognostic factors. Based on these variables, a nomogram to predict 3, 6, 12, and 24 months survival probability after GC surgery was developed. KM and boxplots according to the range of nomogram total points highlighted the appropriateness of distinguish the patients' survival in all the subgroups. Moreover, this nomogram exhibited superior prognostic discrimination between intermediate stages (II-III) than AJCC-TNM classification. This study showed that after good surgical selection, the prognosis of elderly GC patients may be influenced by several clinicopathological factors. Therefore, a predictive nomogram to distinguish more accurately fit patients may allow physicians to individualize treatments and to detect those patients who may benefit from an intensive multidisciplinary approach.