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

 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 
 ANNALS OF SURGERY, Vol.264(1) : 114-120, 2016 
Journal Title
Issue Date
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
gastrectomy ; nomogram ; staging ; stomach neoplasm
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Won(김종원)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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