Abstract
The SOURCE prediction model predicts individualised survival conditional on various treatments for patients with metastatic oesophageal or gastric cancer. The aim of this study was to validate SOURCE in an external cohort from the Belgian Cancer Registry. Data of Belgian patients diagnosed with metastatic disease between 2004 and 2014 were extracted (n = 4097). Model calibration and discrimination (c-indices) were determined. A total of 2514 patients with oesophageal cancer and 1583 patients with gastric cancer with a median survival of 7.7 and 5.4 months, respectively, were included. The oesophageal cancer model showed poor calibration (intercept: 0.30, slope: 0.42) with an absolute mean prediction error of 14.6%. The mean difference between predicted and observed survival was −2.6%. The concordance index (c-index) of the oesophageal model was 0.64. The gastric cancer model showed good calibration (intercept: 0.02, slope: 0.91) with an absolute mean prediction error of 2.5%. The mean difference between predicted and observed survival was 2.0%. The c-index of the gastric cancer model was 0.66. The SOURCE gastric cancer model was well calibrated and had a similar performance in the Belgian cohort compared with the Dutch internal validation. However, the oesophageal cancer model had not. Our findings underscore the importance of evaluating the performance of prediction models in other populations.
Highlights
Figure depicts the selection process stratified by oesophageal and gastric cancer patients
External validation of prediction models is essential for use in clinical practice [18]
This external validation study of the Dutch SOURCE model demonstrated that the oesophageal model had low transportability to the Belgian population, given its poor calibration and c-index
Summary
Cancers 2020, 12, x face a median overall survival (OS) time of three to five months with best supportive care (BSC) [1,2]. Survival is dependent on various prognostic factors and treatment type [3]. Patients with a relatively good Cooperative Oncology. Group Performance (PS) of Oesophagogastric cancer hasEastern a dismal prognosis. 0–2, may be eligible for chemotherapy, targeted therapy, or even palliative surgery [4,5]. Face a median overall survival (OS) time of three to five months with best supportive care (BSC) [1,2]. Brachytherapy, external radiotherapy, or stent maytype be deployed to relieve symptoms, Survival is dependent on various prognostic factorsplacement and treatment [3]
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