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Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas

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Abstract

Background and Aims

The objective of this study was to construct and authenticate nomograms to project overall survival (OS) and cancer-specific survival (CSS) in primary gastrointestinal non-Hodgkin lymphomas (PGINHL).

Methods

Suitable patients were chosen from the Surveillance, Epidemiology and End Results database and Wannan Medical College Yijishan Hospital. The Cox regression model was used to acquire independent predictive factors to develop nomograms for projecting OS and CSS. The performance of the nomograms was validated using the Harrell’s concordance index (C-index), calibration curves, and decision curve analysis (DCA) and was compared with that of the AJCC 7th staging system. Survival curves were obtained using the Kaplan–Meier method, while the log-rank test was used to compare the difference among the groups.

Results

The C-index of the nomograms for OS and CSS was 0.735 (95% CI = 0.719–0.751) and 0.761 (95% CI = 0.739–0.783), respectively, signifying substantial predictive accuracy. These outcomes were reproducible when the nomograms were used for the internal and external validation cohorts. Moreover, assessments of the C-index, AUC, and DCA between the nomogram results and the AJCC 7th staging system showed that the former was better for evaluation and was more clinically useful.

Conclusions

We constructed the nomogram which could predict 1-, 3-, and 5-year OS and CSS of patients with PGINHL. Our nomogram showed good performance, suggesting that it can be used as an efficacious instrument for predictive assessment of patients with PGINHL.

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Acknowledgments

The authors acknowledge the efforts of the SEER Program cancer registries in creating the SEER database.

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    Authors and Affiliations

    1. Department of Gastroenterology, Yijishan Hospital, Wannan Medical College, No. 2 West of Zheshan Road, Wuhu, 241000, Anhui Province, China

      Bo Sun, Yang Xia, Yuqian Guo, Chiyi He & Wei Wang

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    1. Bo Sun
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    2. Yang Xia
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    3. Yuqian Guo
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    5. Wei Wang
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    Correspondence to Wei Wang.

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    10620_2020_6078_MOESM1_ESM.tif

    Supplementary figure 1 Kaplan–Meier analysis of OS in PGINHL patients with or without chemotherapy. Abbreviations: OS, overall survival. (TIFF 719 kb)

    10620_2020_6078_MOESM2_ESM.tif

    Supplementary figure 2 Kaplan–Meier analysis of CSS in PGINHL patients with or without chemotherapy. Abbreviations: CSS, cancer-specific survival. (TIFF 588 kb)

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    Sun, B., Xia, Y., Guo, Y. et al. Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas. Dig Dis Sci 65, 3570–3582 (2020). https://doi.org/10.1007/s10620-020-06078-9

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