Research Papers:

Development and external validation of a prognostic nomogram for gastric cancer using the national cancer registry

Jianjun Liu, Qirong Geng, Zhimin Liu, Shangxiang Chen, Jing Guo, Pengfei Kong, YingBo Chen, Wei Li, Zhiwei Zhou, Xiaowei Sun, Youqing Zhan and Dazhi Xu _

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Oncotarget. 2016; 7:35853-35864. https://doi.org/10.18632/oncotarget.8221

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Jianjun Liu1,2,*, Qirong Geng1,3,*, Zhimin Liu1,2,*, Shangxiang Chen1,2,*, Jing Guo1,2, Pengfei Kong1,2, YingBo Chen1,2, Wei Li1,2, Zhiwei Zhou1,2, Xiaowei Sun1,2, Youqing Zhan1,2, Dazhi Xu1,2

1State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

2Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China

3Department of Hematology Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China

*These authors have contributed equally to this work

Correspondence to:

Dazhi Xu, email: [email protected]

Keywords: gastric cancer, nomogram, disease specific survival, SEER, prognosis

Received: November 13, 2015     Accepted: February 28, 2016     Published: March 21, 2016


A nomogram based on both western and eastern populations to estimate the Disease Specific Survival (DSS) of resectable gastric cancer (RGC) has not been established. In current study, we retrospectively analyzed 4,379 RGC patients who underwent curative resection from the Surveillance, Epidemiology, and End Results (SEER) database. Patients diagnosed between 1998 and 2009 were assigned as training set (n= 2,770), and the rest were selected as SEER validation set (n= 1,609). An external validation was performed by a set of independent 1,358 RGC patients after D2 resection from Sun Yat–sen University Cancer Center (SYSUCC) in China. The nomogram was constructed based on the training set. The multivariate analysis identified that patient’s age at diagnosis, race, tumor location, grade, depth of invasion, metastatic lymph node stage (mLNS) and total number of examined lymph node (TLN) were associated with patient’s DSS. The discrimination of this nomogram was superior to that of the 7th edition of AJCC staging system in SEER validation set and SYSUCC validation set (0.73 versus 0.70, p=0.005; 0.76 versus 0.72, p=0.005; respectively). Calibration plots of the nomogram showed that the probability of DSS corresponded to actual observation closely. In conclusion, our nomogram resulted in more–reliable prognostic prediction for RGC patients in general population.

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