Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

Abstract

Background:To develop and validate a nomogram and web-based calculator to predict overall survival (OS) in Caucasian-advanced oesophagogastric adenocarcinoma (AOA) patients undergoing first-line combination chemotherapy.Methods:Nine hundred twenty-four AOA patients treated at 28 Spanish teaching hospitals from January 2008 to September 2014 were used as derivation cohort. The result of an adjusted-Cox proportional hazards regression was represented as a nomogram and web-based calculator. The model was validated in 502 prospectively recruited patients treated between October 2014 and December 2016. Harrell's c-index was used to evaluate discrimination.Results:The nomogram includes seven predictors associated with OS: HER2-positive tumours treated with trastuzumab, Eastern Cooperative Oncology Group performance status, number of metastatic sites, bone metastases, ascites, histological grade, and neutrophil-to-lymphocyte ratio. Median OS was 5.8 (95% confidence interval (CI), 4.5–6.6), 9.4 (95% CI, 8.5–10.6), and 14 months (95% CI, 11.8–16) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the derivation set and 4.6 (95% CI, 3.3–8.1), 12.7 (95% CI, 11.3–14.3), and 18.3 months (95% CI, 14.6–24.2) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the validation set. The nomogram is well-calibrated and reveals acceptable discriminatory capacity, with optimism-corrected c-indices of 0.618 (95% CI, 0.591–0.631) and 0.673 (95% CI, 0.636–0.709) in derivation and validation groups, respectively. The AGAMENON nomogram outperformed the Royal Marsden Hospital (c-index=0.583; P=0.00046) and Japan Clinical Oncology Group prognostic indices (c-index=0.611; P=0.03351).Conclusions:We developed and validated a straightforward model to predict survival in Caucasian AOA patients initiating first-line polychemotherapy. This model can contribute to inform clinical decision-making and optimise clinical trial design.

Efficacy and safety of chemotherapy in older versus non-older patients with advanced gastric cancer: A real-world data, non-inferiority analysis

“…Patients are from the AGAMENON database, a national registry of consecutive cases of AGC, in which 30 Spanish centers and one Chilean center have participated. The study design, characteristics, method, and data quality criteria have been widely communicated elsewhere (9)(10)(11)(12)(13).AGAMENON is a non-interventionist database sponsored by the investigators themselves. Data are collected by means of a web-based data collection tool (http://www.agamenonstudy.com/).…”

“…Relative dose intensity (RDI) was considered to be the DI administered with respect to the planned dose intensity for each schedule. Twenty-two prognostic variables deemed important in gastric cancer in at least one previous study (12) were collected in the registry as possible confounding factors.…”

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

“…Recent nomogram models have provided a more individualized prediction based on a combination of variables. These models have been used to predict the prognosis of many cancers, including intrahepatic cholangiocarcinoma, oesophagogastric adenocarcinoma, urothelial carcinoma, breast cancer, and lung cancer . A nomogram for the prediction of recurrence after curative liver resection developed by Shim et al in 2015 has not been applied for prognosis prediction in patients with negative AFP status.…”

“…These models have been used to predict the prognosis of many cancers, including intrahepatic cholangiocarcinoma, oesophagogastric adenocarcinoma, urothelial carcinoma, breast cancer, and lung cancer. [19][20][21][22] A nomogram for the prediction of recurrence after curative liver resection developed by Shim et al 23 in 2015 has not been applied for prognosis prediction in patients with negative AFP status. In addition, the prediction ability of this nomogram was limited to a 2-year RFS period, and the study patients were at an early stage of the disease.…”

Estimating Survival Probabilities of Advanced Gastric Cancer Patients in the Second-Line Setting: The Gastric Life Nomogram

“…In the Gastric Life nomogram, three variables (ECOG PS, N/L ratio, and peritoneal involvement) are able to predict the 3-and 6-month OS probability in mGC patients deemed eligible for second-line therapy. Noteworthy, a recent nomogram was developed to predict the 1-and 2-year OS probability in mGC patients receiving first-line chemotherapy, and again both ECOG PS and N/L ratio were among the seven variables used to build the model [29].…”