@article{f428a0bddfba44ef8131f896b88220ff,
title = "Development and External Validation of a Nomogram to Predict Recurrence-Free Survival After R0 Resection for Stage II/III Gastric Cancer: An International Multicenter Study",
abstract = "Background: The benefit of adjuvant chemotherapy varies widely among patients with stage II/III gastric cancer (GC), and tools predicting outcomes for this patient subset are lacking. We aimed to develop and validate a nomogram to predict recurrence-free survival (RFS) and the benefits of adjuvant chemotherapy after radical resection in patients with stage II/III GC. Methods: Data on patients with stage II/III GC who underwent R0 resection from January 2010 to August 2014 at Fujian Medical University Union Hospital (FMUUH) (n = 1,240; training cohort) were analyzed by Cox regression to identify independent prognostic factors for RFS. A nomogram including these factors was internally and externally validated in FMUUH (n = 306) and a US cohort (n = 111), respectively. Results: The multivariable analysis identified age, differentiation, tumor size, number of examined lymph nodes, pT stage, pN stage, and adjuvant chemotherapy as associated with RFS. A nomogram including the above 7 factors was significantly more accurate in predicting RFS compared with the 8th AJCC-TNM staging system for patients in the training cohort. The risk of peritoneal metastasis was higher and survival after recurrence was significantly worse among patients calculated by the nomogram to be at high risk than those at low risk. The nomogram's predictive performance was confirmed in both the internal and external validation cohorts. Conclusion: A novel nomogram is available as a web-based tool and accurately predicts long-term RFS for GC after radical resection. The tool can also be used to determine the benefit of adjuvant chemotherapy by comparing scores with and without this intervention.",
keywords = "adjuvant chemotherapy benefit, gastric cancer, nomogram, recurrence patterns, web-based tool",
author = "Jun Lu and Xu, {Bin Bin} and Zheng, {Chao Hui} and Ping Li and Xie, {Jian Wei} and Wang, {Jia Bin} and Lin, {Jian Xian} and Chen, {Qi Yue} and Truty, {Mark J.} and Huang, {Chang Ming}",
note = "Funding Information: This study was funded by the Scientific and technological innovation joint capital projects of Fujian Province (2017Y9004); the Scientific and technological innovation joint capital projects of Fujian Province (2017Y9011); the second batch of special support funds for Fujian Province innovation and entrepreneurship talents (2016B013); Construction Project of Fujian Province Minimally Invasive Medical Center [Grant No. (2017)171]; the Scientific and technological innovation joint capital projects of Fujian Province (2018Y9041); Natural Science Foundation of Fujian Province (2019J01155); Fujian Provincial Science and Technology innovation joint fund project plan (2018Y9005); and Fujian Provincial Health Technology project (2019-ZQN-37). Funding Information: The authors would like to thank all the medical staff who contributed to the maintenance of the medical record database. Funding. This study was funded by the Scientific and technological innovation joint capital projects of Fujian Province (2017Y9004); the Scientific and technological innovation joint capital projects of Fujian Province (2017Y9011); the second batch of special support funds for Fujian Province innovation and entrepreneurship talents (2016B013); Construction Project of Fujian Province Minimally Invasive Medical Center [Grant No. (2017)171]; the Scientific and technological innovation joint capital projects of Fujian Province (2018Y9041); Natural Science Foundation of Fujian Province (2019J01155); Fujian Provincial Science and Technology innovation joint fund project plan (2018Y9005); and Fujian Provincial Health Technology project (2019-ZQN-37). Publisher Copyright: {\textcopyright} Copyright {\textcopyright} 2020 Lu, Xu, Zheng, Li, Xie, Wang, Lin, Chen, Truty and Huang.",
year = "2020",
month = oct,
day = "22",
doi = "10.3389/fonc.2020.574611",
language = "English (US)",
volume = "10",
journal = "Frontiers in Oncology",
issn = "2234-943X",
publisher = "Frontiers Media S. A.",
}