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Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST
Background. More than 50% of operable GEA relapse after curative-intent resection. We aimed at externally validating a nomogram to enable a more accurate estimate of individualized risk in resected GEA. Methods. Medical records of a training cohort (TC) and a validation cohort (VC) of patients under...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500991/ https://www.ncbi.nlm.nih.gov/pubmed/36143086 http://dx.doi.org/10.3390/jcm11185439 |
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author | Salati, Massimiliano De Ruvo, Nicola Giglio, Mariano Cesare Sorrentino, Lorena Esposito, Giuseppe Fenocchi, Sara Cucciarrè, Giovanni Serra, Francesco Rossi, Elena Giulia Vittimberga, Giovanni Radi, Giorgia Solaini, Leonardo Morgagni, Paolo Grizzi, Giulia Ratti, Margherita Gelsomino, Fabio Spallanzani, Andrea Ghidini, Michele Ercolani, Giorgio Dominici, Massimo Gelmini, Roberta |
author_facet | Salati, Massimiliano De Ruvo, Nicola Giglio, Mariano Cesare Sorrentino, Lorena Esposito, Giuseppe Fenocchi, Sara Cucciarrè, Giovanni Serra, Francesco Rossi, Elena Giulia Vittimberga, Giovanni Radi, Giorgia Solaini, Leonardo Morgagni, Paolo Grizzi, Giulia Ratti, Margherita Gelsomino, Fabio Spallanzani, Andrea Ghidini, Michele Ercolani, Giorgio Dominici, Massimo Gelmini, Roberta |
author_sort | Salati, Massimiliano |
collection | PubMed |
description | Background. More than 50% of operable GEA relapse after curative-intent resection. We aimed at externally validating a nomogram to enable a more accurate estimate of individualized risk in resected GEA. Methods. Medical records of a training cohort (TC) and a validation cohort (VC) of patients undergoing radical surgery for c/uT2-T4 and/or node-positive GEA were retrieved, and potentially interesting variables were collected. Cox proportional hazards in univariate and multivariate regressions were used to assess the effects of the prognostic factors on OS. A graphical nomogram was constructed using R software’s package Regression Modeling Strategies (ver. 5.0-1). The performance of the prognostic model was evaluated and validated. Results. The TC and VC consisted of 185 and 151 patients. ECOG:PS > 0 (p < 0.001), angioinvasion (p < 0.001), log (Neutrophil/Lymphocyte ratio) (p < 0.001), and nodal status (p = 0.016) were independent prognostic values in the TC. They were used for the construction of a nomogram estimating 3- and 5-year OS. The discriminatory ability of the model was evaluated with the c-Harrell index. A 3-tier scoring system was developed through a linear predictor grouped by 25 and 75 percentiles, strengthening the model’s good discrimination (p < 0.001). A calibration plot demonstrated a concordance between the predicted and actual survival in the TC and VC. A decision curve analysis was plotted that depicted the nomogram’s clinical utility. Conclusions. We externally validated a prognostic nomogram to predict OS in a joint independent cohort of resectable GEA; the NOMOGAST could represent a valuable tool in assisting decision-making. This tool incorporates readily available and inexpensive patient and disease characteristics as well as immune-inflammatory determinants. It is accurate, generalizable, and clinically effectivex. |
format | Online Article Text |
id | pubmed-9500991 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95009912022-09-24 Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST Salati, Massimiliano De Ruvo, Nicola Giglio, Mariano Cesare Sorrentino, Lorena Esposito, Giuseppe Fenocchi, Sara Cucciarrè, Giovanni Serra, Francesco Rossi, Elena Giulia Vittimberga, Giovanni Radi, Giorgia Solaini, Leonardo Morgagni, Paolo Grizzi, Giulia Ratti, Margherita Gelsomino, Fabio Spallanzani, Andrea Ghidini, Michele Ercolani, Giorgio Dominici, Massimo Gelmini, Roberta J Clin Med Article Background. More than 50% of operable GEA relapse after curative-intent resection. We aimed at externally validating a nomogram to enable a more accurate estimate of individualized risk in resected GEA. Methods. Medical records of a training cohort (TC) and a validation cohort (VC) of patients undergoing radical surgery for c/uT2-T4 and/or node-positive GEA were retrieved, and potentially interesting variables were collected. Cox proportional hazards in univariate and multivariate regressions were used to assess the effects of the prognostic factors on OS. A graphical nomogram was constructed using R software’s package Regression Modeling Strategies (ver. 5.0-1). The performance of the prognostic model was evaluated and validated. Results. The TC and VC consisted of 185 and 151 patients. ECOG:PS > 0 (p < 0.001), angioinvasion (p < 0.001), log (Neutrophil/Lymphocyte ratio) (p < 0.001), and nodal status (p = 0.016) were independent prognostic values in the TC. They were used for the construction of a nomogram estimating 3- and 5-year OS. The discriminatory ability of the model was evaluated with the c-Harrell index. A 3-tier scoring system was developed through a linear predictor grouped by 25 and 75 percentiles, strengthening the model’s good discrimination (p < 0.001). A calibration plot demonstrated a concordance between the predicted and actual survival in the TC and VC. A decision curve analysis was plotted that depicted the nomogram’s clinical utility. Conclusions. We externally validated a prognostic nomogram to predict OS in a joint independent cohort of resectable GEA; the NOMOGAST could represent a valuable tool in assisting decision-making. This tool incorporates readily available and inexpensive patient and disease characteristics as well as immune-inflammatory determinants. It is accurate, generalizable, and clinically effectivex. MDPI 2022-09-16 /pmc/articles/PMC9500991/ /pubmed/36143086 http://dx.doi.org/10.3390/jcm11185439 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Salati, Massimiliano De Ruvo, Nicola Giglio, Mariano Cesare Sorrentino, Lorena Esposito, Giuseppe Fenocchi, Sara Cucciarrè, Giovanni Serra, Francesco Rossi, Elena Giulia Vittimberga, Giovanni Radi, Giorgia Solaini, Leonardo Morgagni, Paolo Grizzi, Giulia Ratti, Margherita Gelsomino, Fabio Spallanzani, Andrea Ghidini, Michele Ercolani, Giorgio Dominici, Massimo Gelmini, Roberta Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title | Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title_full | Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title_fullStr | Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title_full_unstemmed | Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title_short | Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST |
title_sort | development and multicenter validation of a novel immune-inflammation-based nomogram to predict survival in western resectable gastric and gastroesophageal junction adenocarcinoma (gea): the nomogast |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500991/ https://www.ncbi.nlm.nih.gov/pubmed/36143086 http://dx.doi.org/10.3390/jcm11185439 |
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