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A Nomogram to Predict Overall Survival and Disease-Free Survival After Curative Resection of Gastric Adenocarcinoma

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The American Cancer Society projects there will be over 22,000 new cases, resulting in nearly 11,000 deaths, related to gastric adenocarcinoma in the US in 2014. The aim of the current study was to find clinicopathologic variables associated with disease-free survival (DFS) and overall survival (OS) following curative resection of gastric adenocarcinoma, and create a nomogram for individual risk prediction.

Methods

A nomogram to predict DFS and OS following surgical resection of gastric adenocarcinoma was constructed using a multi-institutional cohort of patients who underwent surgery for primary gastric adenocarcinoma at seven major institutions in the US between January 2000 and August 2013. Discrimination and calibration of the nomogram were tested by C-statistic, Kaplan–Meier curves, and calibration plots.

Results

A total of 719 patients who underwent surgery for primary gastric adenocarcinoma were included in the study. Using the backward selection of clinically relevant variables with Akaike information criteria, age, sex, tumor site, depth of invasion, and lymph node ratio (LNR) were selected as factors predictive of OS, while age, tumor site, depth of invasion, and LNR were incorporated in the prediction of DFS. A nomogram was constructed to predict OS and DFS using these variables. Discrimination and calibration of the nomogram revealed good predictive abilities (C-index, DFS 0.711; OS 0.702).

Conclusion

Independent predictors of recurrence and death following surgery for primary gastric adenocarcinoma were used to create a nomogram to predict DFS and OS. The nomogram was able to stratify patients into prognostic groups, and performed well on internal validation.

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Disclosure

Yuhree Kim, Gaya Spolverato, Aslam Ejaz, Malcolm H. Squires, George Poultsides, Ryan C. Fields, Mark Bloomston, Sharon M. Weber, Konstantinos Votanopoulos, Alexandra W. Acher, Linda X. Jin, BS, William G. Hawkins, Carl Schmidt, David Kooby, David Worhunsky, Neil Saunders, Edward A. Levine, Clifford S. Cho, Shishir K. Maithel, Timothy M. Pawlik have nothing to disclose.

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Authors and Affiliations

  1. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Yuhree Kim MD, MPH, Gaya Spolverato MD, Aslam Ejaz MD, MPH & Timothy M. Pawlik MD, MPH, PhD, FACS

  2. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA

    Malcolm H. Squires MD, David Kooby MD & Shishir K. Maithel MD

  3. Department of Surgery, Stanford University, Stanford, CA, USA

    George Poultsides MD & David Worhunsky MD

  4. Department of Surgery, Washington University, St. Louis, MO, USA

    Ryan C. Fields MD, Linda X. Jin BS & William G. Hawkins MD

  5. Department of Surgery, The Ohio State University, Columbus, OH, USA

    Mark Bloomston MD, Carl Schmidt MD & Neil Saunders MD

  6. Division of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA

    Sharon M. Weber MD, Alexandra W. Acher BE & Clifford S. Cho MD

  7. Department of Surgery, Wake Forest University, Winston-Salem, NC, USA

    Konstantinos Votanopoulos MD & Edward A. Levine MD

  8. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA

    Timothy M. Pawlik MD, MPH, PhD, FACS

Authors
  1. Yuhree Kim MD, MPH
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  2. Gaya Spolverato MD
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  3. Aslam Ejaz MD, MPH
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  6. Ryan C. Fields MD
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  9. Konstantinos Votanopoulos MD
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  10. Alexandra W. Acher BE
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  11. Linda X. Jin BS
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  13. Carl Schmidt MD
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  14. David Kooby MD
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  15. David Worhunsky MD
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  16. Neil Saunders MD
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  17. Edward A. Levine MD
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  18. Clifford S. Cho MD
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  19. Shishir K. Maithel MD
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  20. Timothy M. Pawlik MD, MPH, PhD, FACS
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Corresponding author

Correspondence to Timothy M. Pawlik MD, MPH, PhD, FACS.

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Kim, Y., Spolverato, G., Ejaz, A. et al. A Nomogram to Predict Overall Survival and Disease-Free Survival After Curative Resection of Gastric Adenocarcinoma. Ann Surg Oncol 22, 1828–1835 (2015). https://doi.org/10.1245/s10434-014-4230-4

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  • DOI: https://doi.org/10.1245/s10434-014-4230-4

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