First Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Gastroenterology Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Updates Surg. 2021 Oct;73(5):1879-1890. doi: 10.1007/s13304-021-01083-7. Epub 2021 Jun 14.
An individual prediction of DFS and OS may be useful after surgery for gastric cancer to inform patients and to guide the clinical management. Patients who underwent curative-intent resection for gastric cancer between January 2010 and May 2020 at a single Italian institution were identified. Variables associated with OS and DFS were recorded and analysed according to univariable and multivariable Cox models. Nomograms predicting OS and DFS were built according to variables resulting from multivariable Cox models. Discrimination ability was calculated using the Harrell's Concordance Index. Overall, 168 patients underwent curative-intent resection. Nomograms to predict OS were developed including age, tumor size, tumor location, T stage, N stage, M stage and post-operative complications, while nomogram to predict DFS includes Lauren classification, and lymph node ratio (LNR). On internal validation, both nomograms demonstrated a good discrimination with a Harrell's C-index of 0.77 for OS and 0.71 for DFS. The proposed nomogram to predict DFS and OS after curative-intent surgery for gastric cancer showed a good discrimination on internal validation, and may be useful to guide clinician decision-making, as well help identify patients with high-risk of recurrence or with a poor estimated survival.
个体预测 DFS 和 OS 在胃癌手术后可能有用,可告知患者并指导临床管理。在意大利的一个单一机构,从 2010 年 1 月至 2020 年 5 月,对接受胃癌根治性切除术的患者进行了识别。根据单变量和多变量 Cox 模型记录和分析与 OS 和 DFS 相关的变量。根据多变量 Cox 模型的结果,建立了预测 OS 和 DFS 的列线图。使用 Harrell's 一致性指数计算判别能力。总体而言,168 名患者接受了根治性切除术。建立了预测 OS 的列线图,包括年龄、肿瘤大小、肿瘤位置、T 分期、N 分期、M 分期和术后并发症,而预测 DFS 的列线图包括 Lauren 分类和淋巴结比率(LNR)。在内部验证中,两个列线图都表现出良好的判别能力,OS 的 Harrell's C 指数为 0.77,DFS 的为 0.71。用于预测胃癌根治术后 DFS 和 OS 的新列线图在内部验证中具有良好的判别能力,可用于指导临床医生的决策,以及帮助识别复发风险高或估计生存不良的患者。