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Premium External validation of a multi‐institutional retroperitoneal sarcoma nomogram
Author(s)
Raut Chandrajit P.,
Miceli Rosalba,
Strauss Dirk C.,
Swallow Carol J.,
Hohenberger Peter,
van Coevorden Frits,
Rutkowski Piotr,
Fiore Marco,
Callegaro Dario,
Casali Paolo G.,
Haas Rick L.,
Hayes Andrew J.,
Honore Charles,
Cannell Amanda J.,
Jakob Jens,
Szacht Milena,
Fairweather Mark,
Pollock Raphael E.,
Bonvalot Sylvie,
Gronchi Alessandro
Publication year2016
Publication title
cancer
Resource typeJournals
PublisherWiley-Blackwell
BACKGROUND A multi‐institutional nomogram for predicting disease‐free survival (DFS) and overall survival (OS) in patients with primary retroperitoneal sarcoma (RPS) incorporating relevant prognostic factors not included in the American Joint Committee on Cancer staging system for soft tissue sarcoma has been reported. The authors validated this nomogram with an independent, transatlantic cohort. METHODS Data from patients with RPS who were undergoing definitive resection at 1 of 6 sarcoma centers in Europe and North America (“validation set”) were used to validate a RPS nomogram developed from 3 other centers (“development set”). The nomogram incorporated 6 variables: age, tumor size, grade, histologic subtype, multifocality, and quality of surgery. Nomogram‐predicted probabilities were stratified into 6 subgroups and compared with observed outcomes. Discriminative ability was quantified by Harrell C statistics. RESULTS The validation and development sets included 631 and 523 patients, respectively, all of whom underwent surgical resection at the institutions represented. The 7‐year DFS and OS rates for the validation set were 38% (95% confidence interval, 34%‐43%) and 58% (95% confidence interval, 53%‐63%), respectively. All 6 nomogram variables were found to be independently prognostic. The corrected Harrell C statistics concordance index values for the validation set were 0.69 for DFS and 0.73 for OS, which were similar to those for the development set, suggesting good calibration of the nomogram in the validation cohort. CONCLUSIONS The RPS nomogram was externally validated using a larger, independent cohort. The nomogram can be generalized to patients undergoing surgery for RPS by specialized sarcoma surgeons at sarcoma centers. The nomogram provides a more individualized and disease‐relevant estimation of OS compared with the American Joint Committee on Cancer classification. Cancer 2016;122:1417–1424 . © 2016 American Cancer Society .
Subject(s)cohort , concordance , confidence interval , medicine , nomogram , oncology , overall survival , pathology , prognostic variable , radiology , retrospective cohort study , sarcoma , soft tissue sarcoma , surgery
Language(s)English
SCImago Journal Rank3.052
H-Index304
eISSN1097-0142
pISSN0008-543X
DOI10.1002/cncr.29931

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