Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery
Background. Neoadjuvant chemotherapy (NAC) with subsequent radical surgery has become a popular treatment modality for advanced gastric cancer (AGC) worldwide. However, the survival benefit is still controversial, and prognostic factors remain undetermined. Aim. To identify clinical parameters that...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/2923700 |
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| author | Yonghe Chen Dan Liu Jian Xiao Jun Xiang Aihong Liu Shi Chen Junjie Liu Xiansheng Hu Junsheng Peng |
| author_facet | Yonghe Chen Dan Liu Jian Xiao Jun Xiang Aihong Liu Shi Chen Junjie Liu Xiansheng Hu Junsheng Peng |
| author_sort | Yonghe Chen |
| collection | DOAJ |
| description | Background. Neoadjuvant chemotherapy (NAC) with subsequent radical surgery has become a popular treatment modality for advanced gastric cancer (AGC) worldwide. However, the survival benefit is still controversial, and prognostic factors remain undetermined. Aim. To identify clinical parameters that are associated with the survival of AGC patients after NAC and radical surgery and to establish a nomogram integrating multiple factors to predict survival. Methods. We reviewed the medical profiles of 215 AGC patients who received NAC and radical resection, and clinical parameters concerning NAC, surgery, pathological findings, and adjuvant chemotherapy were analyzed using a Cox regression model to determine their impact on survival. Based on these factors, a nomogram was developed and validated. Results. The overall 1-year and 3-year survival rates were 85.8% and 55.6%, respectively. Younger age (<60 years old), increased examined lymph nodes (exLNs), successful R0 resection, the achievement of pathological complete response (pCR), and acceptance of adjuvant chemotherapy were positive predictors of survival. The C-index of the established nomogram was 0.785. The area under receiver operating curve (ROC) at 1/3 years of prediction was 0.694/0.736, respectively. The model showed an ideal calibration following internal bootstrap validation. Conclusion. A nomogram predicting survival after NAC and surgery was established. Since this nomogram exhibited satisfactory and stable predictive power, it can be inferred that this is a practical tool for predicting AGC patient survival after NAC and radical surgery. |
| format | Article |
| id | doaj-art-4152a503f8ba4058ae5d3234007667c6 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-4152a503f8ba4058ae5d3234007667c62025-02-03T07:23:28ZengWileyGastroenterology Research and Practice1687-61211687-630X2021-01-01202110.1155/2021/29237002923700Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical SurgeryYonghe Chen0Dan Liu1Jian Xiao2Jun Xiang3Aihong Liu4Shi Chen5Junjie Liu6Xiansheng Hu7Junsheng Peng8Department of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Laboratory Science, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510105, ChinaGuangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaDepartment of Gastric Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, ChinaBackground. Neoadjuvant chemotherapy (NAC) with subsequent radical surgery has become a popular treatment modality for advanced gastric cancer (AGC) worldwide. However, the survival benefit is still controversial, and prognostic factors remain undetermined. Aim. To identify clinical parameters that are associated with the survival of AGC patients after NAC and radical surgery and to establish a nomogram integrating multiple factors to predict survival. Methods. We reviewed the medical profiles of 215 AGC patients who received NAC and radical resection, and clinical parameters concerning NAC, surgery, pathological findings, and adjuvant chemotherapy were analyzed using a Cox regression model to determine their impact on survival. Based on these factors, a nomogram was developed and validated. Results. The overall 1-year and 3-year survival rates were 85.8% and 55.6%, respectively. Younger age (<60 years old), increased examined lymph nodes (exLNs), successful R0 resection, the achievement of pathological complete response (pCR), and acceptance of adjuvant chemotherapy were positive predictors of survival. The C-index of the established nomogram was 0.785. The area under receiver operating curve (ROC) at 1/3 years of prediction was 0.694/0.736, respectively. The model showed an ideal calibration following internal bootstrap validation. Conclusion. A nomogram predicting survival after NAC and surgery was established. Since this nomogram exhibited satisfactory and stable predictive power, it can be inferred that this is a practical tool for predicting AGC patient survival after NAC and radical surgery.http://dx.doi.org/10.1155/2021/2923700 |
| spellingShingle | Yonghe Chen Dan Liu Jian Xiao Jun Xiang Aihong Liu Shi Chen Junjie Liu Xiansheng Hu Junsheng Peng Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery Gastroenterology Research and Practice |
| title | Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery |
| title_full | Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery |
| title_fullStr | Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery |
| title_full_unstemmed | Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery |
| title_short | Nomogram for Predicting Survival in Advanced Gastric Cancer after Neoadjuvant Chemotherapy and Radical Surgery |
| title_sort | nomogram for predicting survival in advanced gastric cancer after neoadjuvant chemotherapy and radical surgery |
| url | http://dx.doi.org/10.1155/2021/2923700 |
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