A novel prediction model of prognosis after gastrectomy for gastric carcinoma

Yanghee Woo, Taeil Son, Kijun Song, Naoki Okumura, Yanfeng Hu, Gyu Seok Cho, Jong Won Kim, Seung Ho Choi, Sung Hoon Noh, Woo Jin Hyung

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)


Objective: The prognoses of gastric cancer patients vary greatly among countries. Meanwhile, tumor-node-metastasis (TNM) staging system shows limited accuracy in predicting patient-specific survival for gastric cancer. The objective of this study was to create a simple, yet universally applicable survival prediction model for surgically treated gastric cancer patients. Summary Background Data: A prediction model of 5-year overall survival for surgically treated gastric cancer patients regardless of curability was developed using a test data set of 11,851 consecutive patients. Methods: The model's coefficients were selected based on univariate and multivariate analysis of patient, tumor, and surgical factors shown to significantly impact survival using a Cox proportional hazards model. For internal validation, discrimination was calculated with the concordance index (C-statistic) using the bootstrap method and calibration assessed. The model was externally validated using 4 data sets from 3 countries. Results: Our model's C-statistic (0.824) showed better discrimination power than current tumor-node-metastasis staging (0.788) (P < 0.0001). Bootstrap internal validation demonstrated that coefficients remained largely unchanged between iterations, with an average C-statistic of 0.822. The model calibration was accurate in predicting 5-year survival. In the external validation, C-statistics showed good discrimination (range: 0.798-0.868) in patient data sets from 4 participating institutions in 3 different countries. Conclusions: Utilizing clinically practical patient, tumor, and surgical information, we developed a universally applicable prediction model for accurately determining the 5-year overall survival of gastric cancer patients after gastrectomy. Our predictive model was also valid in patients who underwent noncurative resection or inadequate lymphadenectomy.

Original languageEnglish
Pages (from-to)114-120
Number of pages7
JournalAnnals of surgery
Issue number1
Publication statusPublished - 2016 Jul 1

Bibliographical note

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.

All Science Journal Classification (ASJC) codes

  • Surgery


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