Background: The US guidelines for gastric cancer (GC) recommend adjuvant radiotherapy (ART) combined with 5-fluorouracil as a standard treatment for patients with resected locally advanced GC. However, patient selection criteria for optimizing the use of adjuvant therapies are lacking. In this study, we developed and validated a nomogram to predict the individualized overall survival (OS) benefit of ART among patients with resected >= stage IB GC. Patients and Methods: The 2002-2006 Surveillance, Epidemiology, and End Results (SEER) data of 5,206 patients with resected GC were used as a training set for the development of a nomogram. The 2007-2008 SEER data of 1,986 patients with resected GC were used as validation data. Results: In the multivariate analysis weighted by inverse propensity score, the efficacy of ART varied by the ratio of positive to examined nodes (P-interaction<0.01). The magnitude of this difference was included in the nomogram with associated prognosticators to predict the 3- and 5-year OS with and without ART. The nomogram showed significant prognostic superiority to the 8th TNM staging in the training set (Concordance index, 0.68 versus 0.65; P < 0.01) and the validation set (Concordance index, 0.68 versus 0.64; P < 0.01). Moreover, the calibration was accurate, and the actual efficacy of ART was positively correlated with the nomogram-estimated survival benefit from ART (P-interaction < 0.01 and P-interaction = 0.02 in the training set and the validation set, respectively). Conclusion: The nomogram can aid individualized clinical decision making by estimating the 3-and 5-year OS and potential benefits of ART among patients with resected GC.
基金:
National High Technology Research and Development Program of China (863 Program), ChinaNational High Technology Research and Development Program of China [2015AA020103]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81372570, 81572392]; Science and Technology Program of Guangdong Province, China [201508020247]; Medical Scientific Research of Guangdong province [B201416]; China Scholarship CouncilChina Scholarship Council [201406385034]; Science and Technology Planning Project of Guangdong Province [2013A022100023]
语种:
外文
被引次数:
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PubmedID:
中科院(CAS)分区:
出版当年[2017]版:
大类|3 区医学
小类|3 区肿瘤学
最新[2023]版:
大类|3 区医学
小类|4 区肿瘤学
第一作者:
第一作者机构:[1]Sun Yat Sen Univ, Dept Gastr Surg, Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China;[2]State Key Lab Oncol South China, Guangzhou 510060, Guangdong, Peoples R China;[3]Collaborat Innovat Ctr Canc Med, Guangzhou 510060, Guangdong, Peoples R China;
通讯作者:
通讯机构:[2]State Key Lab Oncol South China, Guangzhou 510060, Guangdong, Peoples R China;[3]Collaborat Innovat Ctr Canc Med, Guangzhou 510060, Guangdong, Peoples R China;[6]Sun Yat Sen Univ, Dept Med Oncol, Canc Ctr, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China;
推荐引用方式(GB/T 7714):
Yuan Shu-Qiang,Wu Wen-Jing,Qiu Miao-Zhen,et al.Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer[J].JOURNAL OF CANCER.2017,8(17):3498-3505.doi:10.7150/jca.19879.
APA:
Yuan, Shu-Qiang,Wu, Wen-Jing,Qiu, Miao-Zhen,Wang, Zi-Xian,Yang, Lu-Ping...&Xu, Rui-Hua.(2017).Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer.JOURNAL OF CANCER,8,(17)
MLA:
Yuan, Shu-Qiang,et al."Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer".JOURNAL OF CANCER 8..17(2017):3498-3505