title: Postoperative nomogram for survival of patients with retroperitoneal sarcoma treated with curative intent.
abstract: BACKGROUND
  Current American Joint Committee on Cancer retroperitoneal sarcoma (RPS) staging is not representative of patients with RPS specifically and has limited discriminative power. Our objective was to develop a RPS disease-specific nomogram capable of stratifying patients based on probability of overall survival (OS) after resection.
  
  
  METHODS
  In all, 1118 RPS patients were evaluated at our institution (1996-2006). Patients with resectable, nonmetastatic disease were selected (n = 343) and baseline, treatment and outcome variables were retrieved. A nomogram was created and its performance was evaluated by calculating its discrimination (concordance index) and calibration and by subsequent internal validation.
  
  
  RESULTS
  Median follow-up and OS were 50 and 59 months, respectively. Independent predictors of OS were included in the nomogram: age (> or = 65), tumor size (> or = 15 cm), type of presentation (primary versus recurrent), multifocality, completeness of resection and histology. The concordance index was 0.73 [95% confidence interval (CI) 0.71-0.75] and the calibration was excellent, with all observed outcomes within the 95% CI of each predicted survival probability.
  
  
  CONCLUSIONS
  A RPS-specific postoperative nomogram was developed. It improves RPS staging by allowing a more dynamic and robust disease-specific risk stratification. This prognostic tool can help in patient counseling and for selection of high-risk patients that may benefit from adjuvant therapies or inclusion into clinical trials.
authors.affiliation: Department of Surgery, Baylor College of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: D A
authors.initials: DA
authors.lastname: Anaya
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: G
authors.initials: G
authors.lastname: Lahat
authors.affiliation: Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: L
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Pisters
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Cormier
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Hunt
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: B W
authors.initials: BW
authors.lastname: Feig
authors.affiliation: Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Lev
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Electronic address: rpollock@mdanderson.org.
authors.forename: R E
authors.initials: RE
authors.lastname: Pollock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D049451:Nomograms; D011184:Postoperative Period; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D012509:Sarcoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D055815:Young Adult