Tumor volume increases the predictive accuracy of prognosis for gastric cancer: A retrospective cohort study of 3409 patients
Metrics: PDF 1226 views | HTML 1553 views | ?
Zhen Liu1,*, Peng Gao2,*, Shushang Liu1,*, Gaozan Zheng1, Jianjun Yang1, Li Sun1, Liu Hong1, Daiming Fan1, Hongwei Zhang1, Fan Feng1
1Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 710032, Xi’an, Shaanxi Province, China
2Department of Radiation Medicine, Faculty of Preventive Medicine, The Fourth Military Medical University, 710032, Xi’an, Shaanxi Province, China
*These authors have contributed equally to this work
Hongwei Zhang, email: [email protected]
Fan Feng, email: [email protected]
Keywords: gastric cancer, tumor volume, prognosis, predictive accuracy
Received: September 26, 2016 Accepted: January 16, 2017 Published: January 27, 2017
Tumor diameter or T stage does not reflect the actual tumor burden and is not able to estimate accurate prognosis of gastric cancer. The current study aimed to evaluate the prognostic value of tumor volume (V) for gastric cancer. A total of 3409 enrolled gastric cancer patients were randomly divided into training set (n = 1705) and validation set (n = 1704). Tumor volume was calculated by the formula V = Tumor diameter × (T stage)2/2. The survival predictive accuracy and prognostic discriminatory ability between different variables and staging systems were analyzed. Four optimal cutoff points for V were obtained in training set (3.5, 8.6, 25.0, 45.0, all P < 0.001). V stage was significantly associated with tumor location, macroscopic type, differentiation degree, tumor diameter, T stage, N stage, vessel invasion, neural invasion and TNM stage (all P < 0.001). V stage was an independent prognostic factor both in training and validation set. V stage showed better predictive accuracy and prognostic discriminatory ability than tumor diameter and T stage. VNM staging system also have advantages in predictive accuracy and prognostic discriminatory ability than TNM staging system. The VNM multivariable model represent good agreement between the predicted survival and actual survival. In conclusion, tumor volume was significantly associated with clinicopathological features and prognosis of gastric cancer. In comparison with TNM staging system, VNM staging system could improve the predictive accuracy and prognostic discriminatory ability for gastric cancer.
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License.