Postoperative Adjuvant Imatinib Therapy-Associated Nomogram to Predict Overall Survival of Gastrointestinal Stromal Tumor.
Postoperative Adjuvant Imatinib Therapy-Associated Nomogram to Predict Overall Survival of Gastrointestinal Stromal Tumor.
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DOI：
10.3389/fmed.2022.777181
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发表时间：
2022
影响因子：
3.9
通讯作者：
Zhou Y
中科院分区：
文献类型：
--
作者：
Liu X;Lin E;Sun Y;Liu X;Li Z;Jiao X;Li Y;Guo D;Zhang P;Feng X;Chen T;Niu Z;Zhou Z;Qiu H;Zhou Y
伊马替尼辅助治疗可显著提高胃肠道间质瘤（GIST）的总生存期（OS）。很少有列线图结合使用辅助伊马替尼和临床病理特征估计患者的结果。我们的目的是建立一个更全面的诺模图来预测GIST患者的OS。在2001年至2015年期间，共有1310名GIST患者在四个高容量医疗中心接受根治性切除术。独立的预后因素进行了多因素考克斯分析。符合条件的患者以7：3的比例随机分配到训练集（916例）和验证集（394例）。用R软件建立诺模图，用时间依赖的受试者工作特征（ROC）曲线和校正图将其预测能力与改良的美国国立卫生研究院（NIH）分类法进行比较。年龄，肿瘤部位，肿瘤大小，有丝分裂指数，术后伊马替尼和诊断延迟被确定为独立的预后参数，并用于构建诺模图。值得注意的是，诊断延迟首次被纳入GIST的预后模型。校准的诺模图导致预测的存活率与观察到的一致。决策曲线分析表明诺模图预测模型具有一定的临床应用价值。时间依赖性ROC曲线显示，在训练集和验证集，诺模图对3年和5年生存预测的区分力均高于改良NIH分类（均P < 0.05）。术后辅助伊马替尼治疗改善了GIST患者的生存率。我们开发并验证了一种更全面的GIST患者预后诺模图，它可能在改善生存风险和治疗决策的个体化预测方面具有重要的临床实用性。
Adjuvant imatinib therapy has been shown to improve overall survival (OS) of gastrointestinal stromal tumor (GIST) significantly. Few nomograms combining the use of adjuvant imatinib and clinicopathological characteristics estimate the outcome of patients. We aimed to establish a more comprehensive nomogram for predicting OS in patients with GIST. In total, 1310 GIST patients undergoing curative resection at four high-volume medical centers between 2001 and 2015 were enrolled. Independent prognostic factors were identified by multivariate Cox analysis. Eligible patients were randomly assigned in a ratio of 7:3 into a training set (916 cases) and a validation set (394 cases). A nomogram was established by R software and its predictive power compared with that of the modified National Institutes of Health (NIH) classification using time-dependent receiver operating characteristic (ROC) curves and calibration plot. Age, tumor site, tumor size, mitotic index, postoperative imatinib and diagnostic delay were identified as independent prognostic parameters and used to construct a nomogram. Of note, diagnostic delay was for the first time included in a prognostic model for GIST. The calibrated nomogram resulted in predicted survival rates consistent with observed ones. And the decision curve analysis suggested that the nomogram prognostic model was clinically useful. Furthermore, time-dependent ROC curves showed the nomogram exhibited greater discrimination power than the modified NIH classification in 3- and 5-year survival predictions for both training and validation sets (all P < 0.05). Postoperative adjuvant imatinib therapy improved the survival of GIST patients. We developed and validated a more comprehensive prognostic nomogram for GIST patients, and it could have important clinical utility in improving individualized predictions of survival risks and treatment decision-making.
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影响因子：
6.3
作者：
Liu, Xuechao;Wu, Zhiming;Zhou, Zhiwei
通讯作者：
Zhou, Zhiwei
影响因子：
3.6
作者：
Vickers, Andrew J.;Elkin, Elena B.
通讯作者：
Elkin, Elena B.
影响因子：
45.3
作者：
Joensuu, Heikki;Eriksson, Mikael;Reichardt, Peter
通讯作者：
Reichardt, Peter
影响因子：
28.4
作者：
Joensuu, Heikki;Wardelmann, Eva;Reichardt, Peter
通讯作者：
Reichardt, Peter
影响因子：
23.4
作者：
Diamand, Romain;Ploussard, Guillaume;Albisinni, Simone
通讯作者：
Albisinni, Simone