A Novel Prediction Model of Prognosis After Gastrectomy for Gastric Carcinoma: Development and Validation Using Asian Databases.
Ann Surg
; 264(1): 114-20, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-26945155
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
/
Adenocarcinoma
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Gastrectomia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article