PURPOSE: The aim of this study was to combine clinicopathologic variables associated with overall survival after gastric resection with D2 lymphadenectomy (D2 gastrectomy) for gastric cancer into a prediction nomogram. PATIENTS AND METHODS: We retrospectively analyzed 7,954 patients who underwent D2 gastrectomy for gastric cancer at Seoul National University Hospital (SNUH) in Seoul, Korea. Two thirds of the patients were randomly assigned to the training set (n = 5,300), and one third were assigned to the validation set (n = 2,654). Multivariate analysis by Cox proportional hazards regression was performed using the training set, and the nomogram was constructed. Discrimination and calibration were performed using the SNUH validation set. Additional external validation was performed using the data set (n = 2,500) from Cancer Institute Ariake Hospital (CIAH) in Tokyo, Japan. RESULTS: The multivariate Cox model identified age at diagnosis, sex, location, depth of invasion, number of metastatic lymph nodes, and number of examined lymph nodes as covariates associated with survival. In the SNUH validation set, the nomogram exhibited superior discrimination power compared with the seventh American Joint Committee on Cancer TNM classification (Harrell's C-index, 0.78 v 0.69, respectively; P < .001). Calibration of the nomogram predicted survival corresponding closely with the actual survival. In the CIAH validation set, discrimination was good (C-index, 0.79), and the predicted survival was within a 10% margin of ideal nomogram. CONCLUSION: We developed a nomogram predicting 5- and 10-year overall survival after D2 gastrectomy for gastric cancer. Validation using the SNUH and CIAH data sets revealed good discrimination and calibration, suggesting good clinical utility. The nomogram improved individualized predictions of survival.
RCT Entities:
PURPOSE: The aim of this study was to combine clinicopathologic variables associated with overall survival after gastric resection with D2 lymphadenectomy (D2 gastrectomy) for gastric cancer into a prediction nomogram. PATIENTS AND METHODS: We retrospectively analyzed 7,954 patients who underwent D2 gastrectomy for gastric cancer at Seoul National University Hospital (SNUH) in Seoul, Korea. Two thirds of the patients were randomly assigned to the training set (n = 5,300), and one third were assigned to the validation set (n = 2,654). Multivariate analysis by Cox proportional hazards regression was performed using the training set, and the nomogram was constructed. Discrimination and calibration were performed using the SNUH validation set. Additional external validation was performed using the data set (n = 2,500) from Cancer Institute Ariake Hospital (CIAH) in Tokyo, Japan. RESULTS: The multivariate Cox model identified age at diagnosis, sex, location, depth of invasion, number of metastatic lymph nodes, and number of examined lymph nodes as covariates associated with survival. In the SNUH validation set, the nomogram exhibited superior discrimination power compared with the seventh American Joint Committee on Cancer TNM classification (Harrell's C-index, 0.78 v 0.69, respectively; P < .001). Calibration of the nomogram predicted survival corresponding closely with the actual survival. In the CIAH validation set, discrimination was good (C-index, 0.79), and the predicted survival was within a 10% margin of ideal nomogram. CONCLUSION: We developed a nomogram predicting 5- and 10-year overall survival after D2 gastrectomy for gastric cancer. Validation using the SNUH and CIAH data sets revealed good discrimination and calibration, suggesting good clinical utility. The nomogram improved individualized predictions of survival.
Authors: Jian Ji Pan; Wai Tong Ng; Jing Feng Zong; Sarah W M Lee; Horace C W Choi; Lucy L K Chan; Shao Jun Lin; Qiao Juan Guo; Henry C K Sze; Yun Bin Chen; You Ping Xiao; Wai Kuen Kan; Brian O'Sullivan; Wei Xu; Quynh Thu Le; Christine M Glastonbury; A Dimitrios Colevas; Randal S Weber; William Lydiatt; Jatin P Shah; Anne W M Lee Journal: Cancer Date: 2016-07-19 Impact factor: 6.860
Authors: Michael S Kent; Sumithra J Mandrekar; Rodney Landreneau; Francis Nichols; Nathan R Foster; Thomas A DiPetrillo; Bryan Meyers; Dwight E Heron; David R Jones; Angelina D Tan; Sandra Starnes; Joe B Putnam; Hiran C Fernando Journal: Ann Thorac Surg Date: 2016-04-19 Impact factor: 4.330
Authors: Takanobu Yamada; Takaki Yoshikawa; Masataka Taguri; Tsutomu Hayashi; Toru Aoyama; Henry M Sue-Ling; Kiran Bonam; Jeremy D Hayden; Heike I Grabsch Journal: Gastric Cancer Date: 2015-03-12 Impact factor: 7.370