Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma
Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma
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DOI：
10.1200/jco.2003.01.240
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发表时间：
2003-10-01
影响因子：
45.3
通讯作者：
Brennan, MF
中科院分区：
文献类型：
--
作者：
Kattan, MW;Karpeh, MS;Brennan, MF
目的：很少有已发表的研究讨论了胃癌R0切除术后个体患者的风险。我们开发并内部验证了一个列线图，该列线图结合了这些因素来预测在单一机构治疗的1，039例胃癌患者的5年特异性生存概率。方法：诺模图预测变量包括年龄、性别、原发部位（远端三分之一、中间三分之一、胃食管交界处和近端三分之一），Lauren组织型（弥漫性的、肠的、混合的）、切除的阳性淋巴结的数目、切除的阴性淋巴结的数目和浸润深度。胃癌导致的死亡是预测的终点。一致性指数被用作准确性指标，并使用自举法校正乐观偏倚。校准plots构建。结果：胃癌特异性生存5年为50%。基于考克斯回归模型构建列线图。Bootstrap校正一致性指数为0.80。与美国癌症联合委员会分期预测能力比较，列线图判别力优于上级（P < .001）。诺模图校准似乎是优秀的。结论：诺模图的发展，以预测5年的疾病特异性生存后，R0切除胃癌。这个工具应该是有用的病人咨询，随访计划，临床试验资格的确定。(C)2003年，美国临床肿瘤学会。
Purpose : Few published studies have addressed individual patient risk after R0 resection for gastric cancer. We developed and internally validated a nomogram that combines these factors to predict the probability of 5-year gastric cancer-specific survival on the basis of 1,039 patients treated at a single institution.Methods: Nomogram predictor variables included age, sex, primary site (distal one-third, middle one-third, gastro-esophageal junction, and proximal one-third), Lauren histotype (diffuse, intestinal, mixed), number of positive lymph nodes resected, number of negative lymph nodes resected, and depth of invasion. Death as a result of gastric cancer was the predicted end point. The concordance index was used as an accuracy measure, with bootstrapping to correct for optimistic bias. Calibration plots were constructed.Results: Gastric cancer-specific survival at 5 years was 50%. A nomogram was constructed on the basis of a Cox regression model. The bootstrap-corrected concordance index was 0.80. When compared with the predictive ability of American Joint Committee on Cancer stage, the nomogram discrimination was superior (P < .001). Nomogram calibration appeared to be excellent.Conclusion: A nomogram was developed to predict 5-year disease-specific survival after R0 resection for gastric cancer. This tool should be useful for patient counseling, follow-up scheduling, and clinical trial eligibility determination. (C) 2003 by American Society of Clinical Oncology.