Daniele Marrelli1, Paolo Morgagni2, Giovanni de Manzoni3, Alberto Marchet4, Gian Luca Baiocchi5, Simone Giacopuzzi3, Arianna Coniglio5, Simone Mocellin4, Luca Saragoni6, Franco Roviello7. 1. Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy. Electronic address: daniele.marrelli@unisi.it. 2. Department of Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy. 3. Department of Surgery, University of Verona, Verona, Italy. 4. Department of Surgery, University of Padova, Padova, Italy. 5. Surgical Clinic, University of Brescia, Brescia, Italy. 6. Department of Pathology, Morgagni-Pierantoni Hospital, Forlì, Italy. 7. Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.
Abstract
BACKGROUND: A score predictive of tumor recurrence after radical surgery for non-cardia gastric cancer was previously developed in Italian centers. The aim of this study was to validate the score in a consecutive cohort with prospectively collected follow-up data. STUDY DESIGN: Of 1,178 patients surgically treated between 1998 and 2006, six hundred and thirty-five patients who fulfilled the selection criteria and completed the follow-up program were available for analysis. The score value for each patient was calculated using the formula obtained from a logistic regression model. Discrimination and calibration of the score in the validation group were evaluated and compared with the data of 438 patients in the study group where the score was developed. RESULTS: Most patients in both groups had very low or very high score values. In the validation group, the observed recurrence rates ranged from 5% to 92% in different score strata. The area under the receiver operating characteristic curve was 0.889 (95% CI, 0.864-0.914; p < 0.001), indicating a high discrimination value of the score for recurrence. A good calibration was observed by comparing the predicted risk with the actual risk of recurrence. With a score cut-off value of 50, sensitivity, specificity, and overall accuracy were 74%, 86%, and 81%, respectively. An inverse correlation between the time to recurrence and score level was also estimated (R(2) = 0.119; p < 0.001). CONCLUSIONS: The high predictive value of the score was validated in a consecutive cohort. These results might allow the introduction of the score in clinical practice for Western patients.
BACKGROUND: A score predictive of tumor recurrence after radical surgery for non-cardia gastric cancer was previously developed in Italian centers. The aim of this study was to validate the score in a consecutive cohort with prospectively collected follow-up data. STUDY DESIGN: Of 1,178 patients surgically treated between 1998 and 2006, six hundred and thirty-five patients who fulfilled the selection criteria and completed the follow-up program were available for analysis. The score value for each patient was calculated using the formula obtained from a logistic regression model. Discrimination and calibration of the score in the validation group were evaluated and compared with the data of 438 patients in the study group where the score was developed. RESULTS: Most patients in both groups had very low or very high score values. In the validation group, the observed recurrence rates ranged from 5% to 92% in different score strata. The area under the receiver operating characteristic curve was 0.889 (95% CI, 0.864-0.914; p < 0.001), indicating a high discrimination value of the score for recurrence. A good calibration was observed by comparing the predicted risk with the actual risk of recurrence. With a score cut-off value of 50, sensitivity, specificity, and overall accuracy were 74%, 86%, and 81%, respectively. An inverse correlation between the time to recurrence and score level was also estimated (R(2) = 0.119; p < 0.001). CONCLUSIONS: The high predictive value of the score was validated in a consecutive cohort. These results might allow the introduction of the score in clinical practice for Western patients.
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Authors: Maurizio Degiuli; Giovanni De Manzoni; Alberto Di Leo; Domenico D'Ugo; Erica Galasso; Daniele Marrelli; Roberto Petrioli; Karol Polom; Franco Roviello; Francesco Santullo; Mario Morino Journal: World J Gastroenterol Date: 2016-03-14 Impact factor: 5.742
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Authors: H G van den Boorn; E G Engelhardt; J van Kleef; M A G Sprangers; M G H van Oijen; A Abu-Hanna; A H Zwinderman; V M H Coupé; H W M van Laarhoven Journal: PLoS One Date: 2018-02-08 Impact factor: 3.240
Authors: Cristina DIaz Del Arco; Lourdes Estrada Muñoz; Elena Molina Roldán; Luis Ortega Medina; Soledad García Gómez de Las Heras; Ángela Chávez; MaJesús Fernández Aceñero Journal: Saudi J Gastroenterol Date: 2021 Jan-Feb Impact factor: 2.485