Survival nomogram for curatively resected Korean gastric cancer patients: multicenter retrospective analysis with external validation

• Published in: PloS one 2015-02, Vol.10 (2), p.e0119671-e0119671
• Main Authors: Eom, Bang Wool, Ryu, Keun Won, Nam, Byung-Ho, Park, Yunjin, Lee, Hyuk-Joon, Kim, Min Chan, Cho, Gyu Seok, Kim, Chan Young, Ryu, Seung Wan, Shin, Dong Woo, Hyung, Woo Jin, Lee, Jun Ho
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Antigens; Biometrics; Biopsy; Calibration; Cancer; Cancer patients; Care and treatment; Chemotherapy; Confidence intervals; Data bases; Epidemiology; Female; Gastric cancer; Hospitals; Humans; Lymph nodes; Lymphatic system; Male; Medical prognosis; Medicine; Metastases; Metastasis; Middle Aged; Multicenter Studies as Topic; Multivariate analysis; Neoplasm Grading - methods; Nomograms; Patient outcomes; Patients; Prognosis; Regression analysis; Regression models; Republic of Korea; Retrospective Studies; Statistical analysis; Statistical tests; Stomach cancer; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Survival; Survival Analysis; Tomography
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0119671

A small number of nomograms have been previously developed to predict the individual survival of patients who undergo curative resection for gastric cancer. However, all were derived from single high-volume centers. The aim of this study was to develop and validate a nomogram for gastric cancer patients using a multicenter database. We reviewed the clinicopathological and survival data of 2012 patients who underwent curative resection for gastric cancer between 2001 and 2006 at eight centers. Among these centers, six institutions were randomly assigned to the development set, and the other two centers were assigned to the validation set. Multivariate analysis using the Cox proportional hazard regression model was performed, and discrimination and calibration were evaluated by external validation. Multivariate analyses revealed that age, tumor size, lymphovascular invasion, depth of invasion, and metastatic lymph nodes were significant prognostic factors for overall survival. In the external validation, the concordance index was 0.831 (95% confidence interval, 0.784-0.878), and Hosmer-Lemeshow chi-square statistic was 3.92 (P = 0.917). We developed and validated a nomogram to predict 5-year overall survival after curative resection for gastric cancer based on a multicenter database. This nomogram can be broadly applied even in general hospitals and is useful for counseling patients, and scheduling follow-up.