Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16809
Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab
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DOI: 10.1038/bjc.2017.122
ISSN: 0007-0920
eISSN: 1532-1827
WOS ID: 000402825200005
Scopus EID: 2-s2.0-85020467274
PMID: 28463962
Embase PUI: L616781772
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Custodio, A.; Carmona-Bayonas, A.; Jimenez-Fonseca, P.; Sanchez, M. L.; Viudez, A.; Hernandez, R.; Cano, J. M.; Echavarria, I.; Pericay, C.; Mangas, M.; Visa, L.; Buxo, E.; Garcia, T.; Rodriguez Palomo, A.; Alvarez Mancenido, F.; Lacalle, A.; Macias, I.; Azkarate, A.; Ramchandani, A.; Fernandez Montes, A.; Lopez, C.; Longo, F.; Sanchez Bayona, R.; Limon, M. L.; Diaz-Serrano, A.; Hurtado, A.; Madero, R.; Gomez, C.; Gallego, J.; AGAMENON Study GrpPublication date
2017-06-06Document type
research articleCitation
Custodio A, Carmona-Bayonas A, Jimenez-Fonseca P, Sanchez ML, Viudez A, Hernandez R, et al. Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab. Br J Cancer. 2017 Jun 06;116(12):1526-35. Epub 2017 May 2.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 (Po0.001), 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 (Po0.001), 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.
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https://dx.doi.org/10.1038/bjc.2017.122Keywords
advanced oesophagogastric adenocarcinomapolychemotherapy
HER2
overall survival
nomogram
web-based calculator
MeSH
Tumor BurdenAged, 80 and over
Aged
European Continental Ancestry Group
Esophageal Neoplasms
Bone Neoplasms
Young Adult
Esophagogastric Junction
Trastuzumab
Adult
Adenocarcinoma
Humans
Health Status
Neutrophils
Antineoplastic Combined Chemotherapy Protocols
Ascites
Middle Aged
Neoplasm Grading
Receptor, ErbB-2
Nomograms
Stomach Neoplasms
Survival Rate
Lymphocyte Count
DeCS
Recuento de LinfocitosNeoplasias Gástricas
Tasa de Supervivencia
Receptor ErbB-2
Carga Tumoral
Clasificación del Tumor
Grupo de Ascendencia Continental Europea
Trastuzumab
Adenocarcinoma
Nomogramas
Ascitis
Unión Esofagogástrica
Humanos
Persona de Mediana Edad
Neutrófilos
Adulto Joven
Protocolos de Quimioterapia Combinada Antineoplásica
Estado de Salud
Anciano
Anciano de 80 o más Años
Adulto
Neoplasias Óseas
Neoplasias Esofágicas