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

Abstract

Objective: We built and externally validated a nomogram for predicting the overall survival (OS) probability of advanced gastric cancer patients receiving second-line treatment. Methods: The nomogram was developed on a set of 320 Italian patients and validated on two independent sets (295 Italian and 172 Korean patients). Putative prognostic variables were selected using a random forest model and included in the multivariable Cox model. The nomogram’s performance was evaluated by calibration plot and C index. Results: ECOG performance status, neutrophils to lymphocytes ratio, and peritoneal involvement were selected and included into the multivariable model. The C index was 0.72 (95% CI 0.68–0.75) in the development set, 0.69 (95% CI 0.65–0.73) in the Italian validation set, but only 0.57 (95% CI 0.52–0.62) in the Korean set. While Italian calibrations were quite good, the Korean one was poor. Regarding 6-month OS predictions, calibration was best in both Caucasian cohorts and worst the in Asian one. Conclusions: Our nomogram may be a useful tool to predict 3- or 6-month OS in Caucasian gastric cancer patients eligible for second-line therapy. Based on three easy-to-collect variables, the Gastric Life nomogram may help clinicians improve patient selection for second-line treatments and assist in clinical trial enrollment.

A nomogram to predict overall survival and disease-free survival after curative-intent gastrectomy for gastric cancer

“…To date, ours is the first Italian nomogram predicting OS for GC in all pathological stages. A previous tool was developed to predict OS for advanced GC in the second line setting, after failure of first line chemotherapy [ 25 ]. To our knowledge, this is also the first nomogram that included the effect of post-operative complications on risk of long-term survival and recurrence.…”

Nomogram for predicting the survival of patients with malignant melanoma: A population analysis

“…Zhang et al (32) established a gallbladder cancer-specific survival model to predict the prognosis of patients with non-metastatic gallbladder cancer following non-surgical treatment. Pietrantonio et al (33) established a nomogram for predicting the survival PI of patients with advanced gastric cancer. The SEER database provides a large number of samples for exploring risk factors and developing accurate predictive models.…”

The evolving strategies for the management of patients with metastatic gastric cancer: A narrative review and expert opinion

“…Recently, the modified japan clinical oncology group (JCOG) prognostic index (which incorporated diffuse-type histology and high neutrophil-to-lymphocyte ratio level into the JCOG prognostic index) showed excellent stratification of OS in real-life patients, as it could also help determine the need for treatment changes throughout the patient cancer journey (54). Other prognostic factor analyses/nomograms can be used to aid clinical decision-making in first-, second-, and third-line settings (Table 1) (32,(55)(56)(57).…”