van den Boorn Héctor G, Abu-Hanna Ameen, Ter Veer Emil, van Kleef Jessy Joy, Lordick Florian, Stahl Michael, Ajani Jaffer A, Guimbaud Rosine, Park Se Hoon, Dutton Susan J, Bang Yung-Jue, Boku Narikazu, Mohammad Nadia Haj, Sprangers Mirjam A G, Verhoeven Rob H A, Zwinderman Aeilko H, van Oijen Martijn G H, van Laarhoven Hanneke W M
Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Cancers (Basel). 2019 Feb 5;11(2):187. doi: 10.3390/cancers11020187.
Prediction models are only sparsely available for metastatic oesophagogastric cancer. Because treatment in this setting is often preference-based, decision-making with the aid of a prediction model is wanted. The aim of this study is to construct a prediction model, called SOURCE, for the overall survival in patients with metastatic oesophagogastric cancer. Data from patients with metastatic oesophageal ( = 8010) or gastric ( = 4763) cancer diagnosed during 2005⁻2015 were retrieved from the nationwide Netherlands cancer registry. A multivariate Cox regression model was created to predict overall survival for various treatments. Predictor selection was performed via the Akaike Information Criterion and a Delphi consensus among experts in palliative oesophagogastric cancer. Validation was performed according to a temporal internal-external scheme. The predictive quality was assessed with the concordance-index (c-index) and calibration. The model c-indices showed consistent discriminative ability during validation: 0.71 for oesophageal cancer and 0.68 for gastric cancer. The calibration showed an average slope of 1.0 and intercept of 0.0 for both tumour locations, indicating a close agreement between predicted and observed survival. With a fair c-index and good calibration, SOURCE provides a solid foundation for further investigation in clinical practice to determine its added value in shared decision making.
预测模型在转移性食管癌和胃癌中应用较少。由于这种情况下的治疗通常基于患者偏好，因此需要借助预测模型进行决策。本研究的目的是构建一个名为SOURCE的预测模型，用于预测转移性食管癌和胃癌患者的总生存期。我们从荷兰全国癌症登记处检索了2005年至2015年期间诊断为转移性食管癌（n = 8010）或胃癌（n = 4763）患者的数据。我们创建了一个多变量Cox回归模型来预测各种治疗方法的总生存期。通过赤池信息准则和姑息性食管癌和胃癌专家之间的德尔菲共识进行预测因子选择。根据时间内外部方案进行验证。使用一致性指数（c指数）和校准评估预测质量。在验证过程中，模型的c指数显示出一致的判别能力：食管癌为0.71，胃癌为0.68。校准显示，两个肿瘤部位的平均斜率均为1.0，截距均为0.0，表明预测生存期与观察到的生存期高度一致。SOURCE模型具有较好的c指数和校准效果，为进一步在临床实践中研究其在共同决策中的附加价值奠定了坚实基础。
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