Validation of the Memorial Sloan Kettering Cancer Center nomogram to predict disease-specific survival in a Chinese gastric cancer population receiving postoperative chemoradiotherapy after an R0 resection
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Meng-long Zhou1,3,*, Lei Wang2,3,*, Jia-zhou Wang1,3, Wang Yang1,3, Ran Hu1,3, Gui-chao Li1,3, Wei-qi Sheng2,3, Zhen Zhang1,3
1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China
2Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China
3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
*These authors have contributed equally to this work
Zhen Zhang, email: firstname.lastname@example.org
Wei-qi Sheng, email: email@example.com
Keywords: gastric carcinoma, nomogram, postoperative chemoradiation, patient selection, prognosis
Received: May 11, 2016 Accepted: August 11, 2016 Published: August 29, 2016
The widely validated Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for gastric carcinoma (GC) was developed based on patients who received R0 resection only. The purpose of the current study was to assess the performance of this nomogram in Chinese patients who received postoperative chemoradiotherapy (CRT) after an R0 resection for GC. From 2006 to 2015, the clinical data of 150 eligible patients were retrospectively collected from the Fudan University Shanghai Cancer Center (FUSCC) and used for external validation. The nomogram was validated by means of the concordance index (CI) and a calibration plot. The CI for the nomogram was 0.657, which was lower than the CI of the nomogram for patients who received surgery alone (0.80). In the calibration plot, the gap between the observed and the predicted survival gradually increased as the predicted 5-year disease-specific survival (DSS) decreased. Thus the MSKCC nomogram for GC significantly underestimated the survival of patients in the FUSCC cohort, especially the survival of patients whose predicted 5-year DSS was less than 50%. The current study indicates the potential for the nomogram to be developed as an ideal tool to identify target patients for postoperative CRT.
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