Validation of the Memorial Sloan Kettering Gastric Cancer Post-Resection Survival Nomogram: Does It Stand the Test of Time?

Autor:	Nakauchi M; From the Gastric and Mixed Tumor Service, Department of Surgery (Nakauchi, Court, Coit, Brennan, Strong), Memorial Sloan Kettering Cancer Center, New York, NY., Court CM; From the Gastric and Mixed Tumor Service, Department of Surgery (Nakauchi, Court, Coit, Brennan, Strong), Memorial Sloan Kettering Cancer Center, New York, NY., Tang LH; Gastrointestinal Pathology Service, Department of Pathology (Tang), Memorial Sloan Kettering Cancer Center, New York, NY., Gönen M; Department of Epidemiology and Biostatistics (Gönen), Memorial Sloan Kettering Cancer Center, New York, NY., Janjigian YY; Gastrointestinal Oncology Service, Department of Medicine (Janjigian, Maron), Memorial Sloan Kettering Cancer Center, New York, NY., Maron SB; Gastrointestinal Oncology Service, Department of Medicine (Janjigian, Maron), Memorial Sloan Kettering Cancer Center, New York, NY., Molena D; Thoracic Service, Department of Surgery (Molena), Memorial Sloan Kettering Cancer Center, New York, NY., Coit DG; From the Gastric and Mixed Tumor Service, Department of Surgery (Nakauchi, Court, Coit, Brennan, Strong), Memorial Sloan Kettering Cancer Center, New York, NY., Brennan MF; From the Gastric and Mixed Tumor Service, Department of Surgery (Nakauchi, Court, Coit, Brennan, Strong), Memorial Sloan Kettering Cancer Center, New York, NY., Strong VE; From the Gastric and Mixed Tumor Service, Department of Surgery (Nakauchi, Court, Coit, Brennan, Strong), Memorial Sloan Kettering Cancer Center, New York, NY.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2022 Aug 01; Vol. 235 (2), pp. 294-304. Date of Electronic Publication: 2022 Apr 28.
DOI:	10.1097/XCS.0000000000000251
Abstrakt:	Background: The Memorial Sloan Kettering Cancer Center (MSK) nomogram combined both gastroesophageal junction (GEJ) and gastric cancer patients and was created in an era from patients who generally did not receive neoadjuvant chemotherapy. We sought to reevaluate the MSK nomogram in the era of multidisciplinary treatment for GEJ and gastric cancer. Study Design: Using data on patients who underwent R0 resection for GEJ or gastric cancer between 2002 and 2016, the C-index of prediction for disease-specific survival (DSS) was compared between the MSK nomogram and the American Joint Committee on Cancer (AJCC) 8th edition staging system after segregating patients by tumor location (GEJ or gastric cancer) and neoadjuvant treatment. A new nomogram was created for the group for which both systems poorly predicted prognosis. Results: During the study period, 886 patients (645 gastric and 241 GEJ cancer) underwent up-front surgery, and 999 patients (323 gastric and 676 GEJ) received neoadjuvant treatment. Compared with the AJCC staging system, the MSK nomogram demonstrated a comparable C-index in gastric cancer patients undergoing up-front surgery (0.786 vs 0.753) and a better C-index in gastric cancer patients receiving neoadjuvant treatment (0.796 vs 0.698). In GEJ cancer patients receiving neoadjuvant chemotherapy, neither the MSK nomogram nor the AJCC staging system performed well (C-indices 0.647 and 0.646). A new GEJ nomogram was created based on multivariable Cox regression analysis and was validated with a C-index of 0.718. Conclusions: The MSK gastric cancer nomogram's predictive accuracy remains high. We developed a new GEJ nomogram that can effectively predict DSS in patients receiving neoadjuvant treatment. (Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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