Abstract
An individual prediction of DFS and OS may be useful after surgery for gastric cancer to inform patients and to guide the clinical management. Patients who underwent curative-intent resection for gastric cancer between January 2010 and May 2020 at a single Italian institution were identified. Variables associated with OS and DFS were recorded and analysed according to univariable and multivariable Cox models. Nomograms predicting OS and DFS were built according to variables resulting from multivariable Cox models. Discrimination ability was calculated using the Harrell’s Concordance Index. Overall, 168 patients underwent curative-intent resection. Nomograms to predict OS were developed including age, tumor size, tumor location, T stage, N stage, M stage and post-operative complications, while nomogram to predict DFS includes Lauren classification, and lymph node ratio (LNR). On internal validation, both nomograms demonstrated a good discrimination with a Harrell’s C-index of 0.77 for OS and 0.71 for DFS. The proposed nomogram to predict DFS and OS after curative-intent surgery for gastric cancer showed a good discrimination on internal validation, and may be useful to guide clinician decision-making, as well help identify patients with high-risk of recurrence or with a poor estimated survival.
Highlights
Gastric cancer (GC) is the fifth most common tumor and the third leading cause of cancer-related mortality worldwide, accounting for over 1,000,000 new cases and 783,000 deaths worldwide in 2020 [1]
On EGD, most tumors were located in the antrum (n = 87; 51.8%) or gastric body (n = 41; 24.4%), while fewer were located in the fundus (n = 14; 8.3%) or at the gastroesophageal junction (Siewert III) (n = 16; 9.5%)
We developed nomograms based on a single European institution experience of 10 years of treatment of GC
Summary
Gastric cancer (GC) is the fifth most common tumor and the third leading cause of cancer-related mortality worldwide, accounting for over 1,000,000 new cases and 783,000 deaths worldwide in 2020 [1]. In Italy, 14,500 new cases of GC and 8700 GC-related deaths have been estimated to be in 2020 [2]. Surgery offers the best chances of curative treatment for GC, recurrences occur in 20–50% of patients after surgery [3]. Recurrence typically occurs within 3 years of surgery and is associated with a poor prognosis [3,4,5]. Depth of tumor invasion, nodal metastasis, lymphovascular invasion and Lauren’s classification are the main risk factors associated with recurrence [3,4,5,6]
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