Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection
Abstract Background Patients with HBsAg-positive gastric cancer (GC) are a heterogeneous group, and it is not possible to accurately predict the overall survival (OS) in these patients. Methods We developed and validated a nomogram to help improve prediction of OS in patients with HBsAg-positive GC....
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doaj-86fdb002b7bf4ffa8335c6804191e4382020-11-25T02:04:21ZengBMCJournal of Translational Medicine1479-58762019-03-011711810.1186/s12967-019-1841-3Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infectionYi He0Minjie Mao1Wenjuan Shi2Zhonglian He3Lin Zhang4Xueping Wang5Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Information Section, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Information Section, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract Background Patients with HBsAg-positive gastric cancer (GC) are a heterogeneous group, and it is not possible to accurately predict the overall survival (OS) in these patients. Methods We developed and validated a nomogram to help improve prediction of OS in patients with HBsAg-positive GC. The nomogram was established by a development cohort (n = 245), and the validation cohort included 84 patients. Factors in the nomogram were identified by univariate and multivariate Cox hazard analysis. We tested the accuracy of the nomograms by discrimination and calibration, and plotted decision curves to assess the benefits of nomogram-assisted decisions in a clinical context. Then we evaluated the risk in the two cohort. Results Significant predictors were age, tumor stage, distant metastases, gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP). The proportional-hazards model (nomogram) was based on pre-treatment characteristics. The nomogram had a concordance index (C-index) of 0.812 (95% CI 0.762–0.862), which was superior than the C-index of AJCC TNM Stage (0.755, 95% CI 0.702–0.808). The calibration plot in the validation cohort based on 5 predictors suggested good agreement between actual and nomogram-predicted OS probabilities. The decision curve showed that the nomogram in predicting OS is better than that of TNM staging system in all range. Moreover, patients were divided into three distinct risk groups for OS by the nomogram: low risk group, middle risk group and high risk group, respectively. Conclusion This nomogram, using five pre-treatment characteristics, improves prediction of OS in patients with HBsAg-positive gastric cancer. It represents an improvement in prognostication over the current TNM stage. To generalize the use of this nomogram in other groups, additional validation with data from other institutions is required.http://link.springer.com/article/10.1186/s12967-019-1841-3Gastric cancerPrognosisNomogramLiver function |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yi He Minjie Mao Wenjuan Shi Zhonglian He Lin Zhang Xueping Wang |
spellingShingle |
Yi He Minjie Mao Wenjuan Shi Zhonglian He Lin Zhang Xueping Wang Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection Journal of Translational Medicine Gastric cancer Prognosis Nomogram Liver function |
author_facet |
Yi He Minjie Mao Wenjuan Shi Zhonglian He Lin Zhang Xueping Wang |
author_sort |
Yi He |
title |
Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection |
title_short |
Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection |
title_full |
Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection |
title_fullStr |
Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection |
title_full_unstemmed |
Development and validation of a prognostic nomogram in gastric cancer with hepatitis B virus infection |
title_sort |
development and validation of a prognostic nomogram in gastric cancer with hepatitis b virus infection |
publisher |
BMC |
series |
Journal of Translational Medicine |
issn |
1479-5876 |
publishDate |
2019-03-01 |
description |
Abstract Background Patients with HBsAg-positive gastric cancer (GC) are a heterogeneous group, and it is not possible to accurately predict the overall survival (OS) in these patients. Methods We developed and validated a nomogram to help improve prediction of OS in patients with HBsAg-positive GC. The nomogram was established by a development cohort (n = 245), and the validation cohort included 84 patients. Factors in the nomogram were identified by univariate and multivariate Cox hazard analysis. We tested the accuracy of the nomograms by discrimination and calibration, and plotted decision curves to assess the benefits of nomogram-assisted decisions in a clinical context. Then we evaluated the risk in the two cohort. Results Significant predictors were age, tumor stage, distant metastases, gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP). The proportional-hazards model (nomogram) was based on pre-treatment characteristics. The nomogram had a concordance index (C-index) of 0.812 (95% CI 0.762–0.862), which was superior than the C-index of AJCC TNM Stage (0.755, 95% CI 0.702–0.808). The calibration plot in the validation cohort based on 5 predictors suggested good agreement between actual and nomogram-predicted OS probabilities. The decision curve showed that the nomogram in predicting OS is better than that of TNM staging system in all range. Moreover, patients were divided into three distinct risk groups for OS by the nomogram: low risk group, middle risk group and high risk group, respectively. Conclusion This nomogram, using five pre-treatment characteristics, improves prediction of OS in patients with HBsAg-positive gastric cancer. It represents an improvement in prognostication over the current TNM stage. To generalize the use of this nomogram in other groups, additional validation with data from other institutions is required. |
topic |
Gastric cancer Prognosis Nomogram Liver function |
url |
http://link.springer.com/article/10.1186/s12967-019-1841-3 |
work_keys_str_mv |
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