Survival nomogram for curatively resected Korean gastric cancer patients: multicenter retrospective analysis with external validation.
BACKGROUND
A small number of nomograms have been previously developed to predict the individual survival of patients who undergo curative resection for gastric cancer. However, all were derived from single high-volume centers. The aim of this study was to develop and validate a nomogram for gastric cancer patients using a multicenter database.


METHODS
We reviewed the clinicopathological and survival data of 2012 patients who underwent curative resection for gastric cancer between 2001 and 2006 at eight centers. Among these centers, six institutions were randomly assigned to the development set, and the other two centers were assigned to the validation set. Multivariate analysis using the Cox proportional hazard regression model was performed, and discrimination and calibration were evaluated by external validation.


RESULTS
Multivariate analyses revealed that age, tumor size, lymphovascular invasion, depth of invasion, and metastatic lymph nodes were significant prognostic factors for overall survival. In the external validation, the concordance index was 0.831 (95% confidence interval, 0.784-0.878), and Hosmer-Lemeshow chi-square statistic was 3.92 (P = 0.917).


CONCLUSIONS
We developed and validated a nomogram to predict 5-year overall survival after curative resection for gastric cancer based on a multicenter database. This nomogram can be broadly applied even in general hospitals and is useful for counseling patients, and scheduling follow-up.
Gastric Cancer Branch, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Bang Wool
BW
Eom
Gastric Cancer Branch, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Keun Won
KW
Ryu
Biometric Research Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Byung-Ho
BH
Nam
Biometric Research Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Yunjin
Y
Park
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Hyuk-Joon
HJ
Lee
Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
Min Chan
MC
Kim
Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-do, Republic of Korea.
Gyu Seok
GS
Cho
Department of Surgery, Chonbuk National University Medical School, Jeonju, Jeollabuk-do, Republic of Korea.
Chan Young
CY
Kim
Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea.
Seung Wan
SW
Ryu
Department of Surgery, Bundang Jesaeng Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
Dong Woo
DW
Shin
Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Woo Jin
WJ
Hyung
Gastric Cancer Branch, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Jun Ho
JH
Lee
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D060787:Neoplasm Grading / Q000379:methods; D049451:Nomograms; D056910:Republic of Korea; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis