The prognostic prediction for long-term survival for patients of proximal gastric cancer has not been well established.
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.
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
The 2 nomograms showed accurate pre- and postoperative prediction for long-term survival for patients of proximal gastric cancer.
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All authors have declared no conflicts of interest.