title: Validation of the memorial Sloan-Kettering Cancer Center nomogram to predict disease-specific survival after R0 resection in a Chinese gastric cancer population.
abstract: BACKGROUND
  Prediction of disease-specific survival (DSS) for individual patient with gastric cancer after R0 resection remains a clinical concern. Since the clinicopathologic characteristics of gastric cancer vary widely between China and western countries, this study is to evaluate a nomogram from Memorial Sloan-Kettering Cancer Center (MSKCC) for predicting the probability of DSS in patients with gastric cancer from a Chinese cohort.
  
  
  METHODS
  From 1998 to 2007, clinical data of 979 patients with gastric cancer who underwent R0 resection were retrospectively collected from Peking University Cancer Hospital & Institute and used for external validation. The performance of the MSKCC nomogram in our population was assessed using concordance index (C-index) and calibration plot.
  
  
  RESULTS
  The C-index for the MSKCC predictive nomogram was 0.74 in the Chinese cohort, compared with 0.69 for American Joint Committee on Cancer (AJCC) staging system (P<0.0001). This suggests that the discriminating value of MSKCC nomogram is superior to AJCC staging system for prognostic prediction in the Chinese population. Calibration plots showed that the actual survival of Chinese patients corresponded closely to the MSKCC nonogram-predicted survival probabilities. Moreover, MSKCC nomogram predictions demonstrated the heterogeneity of survival in stage IIA/IIB/IIIA/IIIB disease of the Chinese patients.
  
  
  CONCLUSIONS
  In this study, we externally validated MSKCC nomogram for predicting the probability of 5- and 9-year DSS after R0 resection for gastric cancer in a Chinese population. The MSKCC nomogram performed well with good discrimination and calibration. The MSKCC nomogram improved individualized predictions of survival, and may assist Chinese clinicians and patients in individual follow-up scheduling, and decision making with regard to various treatment options.
authors.affiliation: Center for Bioinformatics, State Key Laboratory of Protein and Plant Gene Research, College of Life Sciences, Peking University, Beijing, China.
authors.forename: Donglai
authors.initials: D
authors.lastname: Chen
authors.forename: Beihai
authors.initials: B
authors.lastname: Jiang
authors.forename: Jiadi
authors.initials: J
authors.lastname: Xing
authors.forename: Maoxing
authors.initials: M
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Cui
authors.forename: Yiqiang
authors.initials: Y
authors.lastname: Liu
authors.forename: Zaozao
authors.initials: Z
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.forename: Chenghai
authors.initials: C
authors.lastname: Zhang
authors.forename: Zhendan
authors.initials: Z
authors.lastname: Yao
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Jiafu
authors.initials: J
authors.lastname: Ji
authors.forename: Hong
authors.initials: H
authors.lastname: Qu
authors.forename: Xiangqian
authors.initials: X
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002173:Cancer Care Facilities; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049451:Nomograms; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000601:surgery