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Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer

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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; [4]Sun Yat Sen Univ, Med Res Ctr, Guangdong Prov Key Lab Malignant Tumor Epigenet &, Mem Hosp, Guangzhou 510120, Guangdong, Peoples R China; [5]Sun Yat Sen Univ, Dept Breast Oncol, Mem Hosp, Guangzhou 510120, 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; [7]Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21231 USA; [8]Sun Yat Sen Univ, Dept Pathol, Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China; [9]Sun Yat Sen Univ, Dept Radiotherapy, Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China
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关键词: gastric cancer adjuvant radiotherapy survival nomogram Surveillance Epidemiology and End Results (SEER)

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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.

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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;
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