P-117 - Nomograms for pre- and postoperative prediction of long-term survival for patients of proximal gastric cancer: A large-scale,single-centre retrospective study

Abstract

Introduction: The prognostic prediction for long-term survival for patients of proximal gastric cancer has not been well established. Methods: Between December 2006 and June 2013, we prospectively collected and retrospectively analyzed the medical records of 746 patients with upper-third gastric cancer (GC). The data were split 75/25, with one group used for model development and the other group used for validation testing. COX regression was used to identify preoperative and postoperative risk factors associated with OS. Results: Among the 746 patients examined, the 1 -, 3 - year overall survival rate is respectively: 89.4%, 66.1%. the preoperative T staging (cT), preoperative N staging (cN), ASA score, preoperative CA199, preoperative tumor size and the weight loss of 3-6 months were incorporated into the preoperative nomogram for overall survival (OS) prediction for the training set. In addition to these variables, LVI, postoperative tumor size, postoperative T stage, postoperative N stage, postoperative blood transfusion and postoperative complications were incorporated into the postoperative nomogram. All calibration curves for probability of OS fitted well. In the training cohort, the preoperative nomogram achieved a C-index of 0.751[95% confidence interval (CI) 0.732-0.770] in predicting OS and accurately stratified patients into 4 prognostic subgroups (5-year OS rates: 86.8%, 73.0%, 43.72% and 20.9%, P < 0.001). The postoperative nomogram had a C-index of 0.758 in predicting OS and accurately stratified patients into 4 prognostic subgroups (5-year OS rates: 82.6%, 74.3%, 45.9% and 18.9%, P < 0.001). Conclusion: The 2 nomograms showed accurate pre- and postoperative prediction for long-term survival for patients of proximal gastric cancer.