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A Novel Prediction Model of Prognosis After Gastrectomy for Gastric Carcinoma: Development and Validation Using Asian Databases.

Authors
 Yanghee Woo  ;  Taeil Son  ;  Kijun Song  ;  Naoki Okumura  ;  Yanfeng Hu  ;  Gyu-Seok Cho  ;  Jong Won Kim  ;  Seung-Ho Choi  ;  Sung Hoon Noh  ;  Woo Jin Hyung 
Citation
 Annals of Surgery, Vol.264(1) : 114-120, 2016 
Journal Title
 Annals of Surgery 
ISSN
 0003-4932 
Issue Date
2016
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology* ; Adenocarcinoma/surgery* ; Female ; Gastrectomy*/methods ; Humans ; Kaplan-Meier Estimate ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Treatment Outcome
Keywords
gastrectomy ; nomogram ; staging ; stomach neoplasm
Abstract
OBJECTIVE: The prognoses of gastric cancer patients vary greatly among countries. Meanwhile, tumor-node-metastasis (TNM) staging system shows limited accuracy in predicting patient-specific survival for gastric cancer. The objective of this study was to create a simple, yet universally applicable survival prediction model for surgically treated gastric cancer patients. SUMMARY BACKGROUND DATA: A prediction model of 5-year overall survival for surgically treated gastric cancer patients regardless of curability was developed using a test data set of 11,851 consecutive patients. METHODS: The model's coefficients were selected based on univariate and multivariate analysis of patient, tumor, and surgical factors shown to significantly impact survival using a Cox proportional hazards model. For internal validation, discrimination was calculated with the concordance index (C-statistic) using the bootstrap method and calibration assessed. The model was externally validated using 4 data sets from 3 countries. RESULTS: Our model's C-statistic (0.824) showed better discrimination power than current tumor-node-metastasis staging (0.788) (P < 0.0001). Bootstrap internal validation demonstrated that coefficients remained largely unchanged between iterations, with an average C-statistic of 0.822. The model calibration was accurate in predicting 5-year survival. In the external validation, C-statistics showed good discrimination (range: 0.798-0.868) in patient data sets from 4 participating institutions in 3 different countries. CONCLUSIONS: Utilizing clinically practical patient, tumor, and surgical information, we developed a universally applicable prediction model for accurately determining the 5-year overall survival of gastric cancer patients after gastrectomy. Our predictive model was also valid in patients who underwent noncurative resection or inadequate lymphadenectomy.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000658-201607000-00019&LSLINK=80&D=ovft
DOI
10.1097/SLA.0000000000001523
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김종원(Kim, Jong Won)
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
손태일(Son, Tae Il) ORCID logo https://orcid.org/0000-0002-0327-5224
송기준(Song, Ki Jun) ORCID logo https://orcid.org/0000-0003-2505-4112
최승호(Choi, Seung Ho) ORCID logo https://orcid.org/0000-0002-9872-3594
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147148
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