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Validation of a nomogram for predicting disease‐specific survival after an R0 resection for gastric carcinoma
Author(s) -
Peeters Koen C. M. J.,
Kattan Michael W.,
Hartgrink Henk H.,
Kranenbarg Elma Klein,
Karpeh Martin S.,
Brennan Murray F.,
van de Velde Cornelis J. H.
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20783
Subject(s) - nomogram , medicine , ajcc staging system , lymph node , cancer , dissection (medical) , gastric carcinoma , oncology , disease , surgery , staging system
BACKGROUND A statistical model for predicting disease‐specific survival in patients with gastric carcinoma, based on a single U.S. institution experience, was tested for validity in a sample of patients treated at different institutions. METHODS The authors analysed 459 patients from the Dutch Gastric Cancer trial that compared limited (D1) with extended (D2) lymph node dissection. The discrimination ability of the nomogram with respect to 5 and 9‐year disease‐specific survival probabilities was superior to that of the American Joint Committee on Cancer (AJCC) staging system. RESULTS There was considerable heterogeneity of risk within many of the AJCC stages. Calibration plots suggested that predicted probabilities from the nomogram corresponded closely to actual disease‐specific survival. The gastric carcinoma nomogram performed well when applied to patients treated in a large number of institutions. CONCLUSIONS The nomogram provided predictions that discriminated better than the AJCC staging system, regardless of the extent of lymph node dissection. Patient counseling and adjuvant therapy decision‐making should benefit from use of the nomogram. Cancer 2005. © 2005 American Cancer Society.