Nomogram for 5-year relapse-free survival of a patient with advanced gastric cancer after surgery
Nomogram for 5-year relapse-free survival of a patient with advanced gastric cancer after surgery
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DOI：
10.1016/j.ijsu.2016.09.080
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发表时间：
2016-11-01
影响因子：
15.3
通讯作者：
Wakai, Toshifumi
中科院分区：
文献类型：
--
作者：
Muneoka, Yusuke;Akazawa, Kohei;Wakai, Toshifumi
背景：根治性手术后晚期胃癌患者的预后差异很大。本研究的目的是开发并验证一种新型列线图的有效性，该列线图可预测接受 II/III 期胃癌根治性切除的患者 5 年无复发生存 (RFS) 的概率。 材料和方法：根据 3 岁时接受原发性胃癌手术的患者数据，构建了预测胃癌手术切除后 5 年无复发生存 (RFS) 的列线图。 2001年1月至2006年12月在日本的机构进行。使用Cox比例风险回归模型进行多变量分析，并通过内部验证评估列线图的预测准确性（辨别力）以及观察结果与预测之间的一致性（校准）。结果：多变量分析显示手术年龄、肿瘤深度、肿瘤位置、淋巴结分类和是否进行联合切除术 是 RFS 的重要预后因素。在内部验证中，所开发的 5 年 RFS 列线图的辨别力优于美国癌症联合委员会 TNM 分类（一致性指数为 0.80 与 0.67；P < 0.001）。此外，校准似乎是准确的。基于这些结果，我们创建了免费软件来更轻松地预测 5 年 RFS。结论：我们开发并验证了列线图来预测 II/III 期胃癌根治性手术后的 5 年 RFS。在临床实践中考虑额外治疗时，该工具将有助于评估患者的个体复发风险。 (C) 2016 IJS Publishing Group Ltd. 由 Elsevier Ltd 出版。保留所有权利。
Background: Prognoses vary substantially among patients with advanced gastric cancer following curative surgery. The aim of the current study was to develop and verify the validity of a novel nomogram that predicts the probability of 5-year relapse-free survival (RFS) in patients who underwent curative resection for stage II/III gastric cancer.Materials and methods: A nomogram to predict 5-year RFS following surgical resection of gastric cancer was constructed based on the data of patients who underwent surgery for primary gastric carcinoma at three institutions in Japan in January 2001-December 2006. Multivariate analysis using a Cox proportional hazards regression model was performed, and the nomogram's predictive accuracy (discrimination) and the agreement between observed outcomes and predictions (calibration) were evaluated by internal validation.Results: Multivariate analyses revealed that age at operation, depth of tumor, tumor location, lymph node classification, and presence of combined resection were significant prognostic factors for RFS. In the internal validation, discrimination of the developed nomogram for 5-year RFS was superior to that of the American Joint Committee on Cancer TNM classification (concordance indices of 0.80 versus 0.67; P < 0.001). Moreover, calibration appeared to be accurate. Based on these results, we have created free software to more easily predict 5-year RFS.Conclusion: We developed and validated a nomogram to predict 5-year RFS after curative surgery for stage II/III gastric cancer. This tool will be useful for the assessing a patient's individual recurrence risk when considering additional therapy in clinical practice. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.