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01.12.2014 | Original Article | Ausgabe 12/2014

Journal of Gastrointestinal Surgery 12/2014

A Nomogram to Predict Disease-Free Survival After Surgical Resection of GIST

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 12/2014
Autoren:
Danielle A. Bischof, Yuhree Kim, Ramy Behman, Paul J. Karanicolas, Fayez A. Quereshy, Dan G. Blazer III, Shishir K. Maithel, T. Clark Gamblin, Todd W. Bauer, Timothy M. Pawlik
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-014-2658-2) contains supplementary material, which is available to authorized users.

Abstract

Background

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Adjuvant imatinib therapy has resulted in improved disease-free survival (DFS) following resection of primary GIST. The aim of our study was to create a nomogram to predict DFS following resection of GIST.

Method

Using a multi-institutional cohort of patients who underwent surgery for primary GIST at 7 academic hospitals in the USA and Canada between January 1998 and December 2012, a multivariable Cox proportional hazards model predicting DFS was created using backward stepwise selection. A nomogram to predict DFS following surgical resection of GIST was constructed with the variables selected in the multivariable model. We tested nomogram discrimination by calculating the C-statistic and compared the nomogram to four existing GIST prognostic stratification systems.

Results

A total of 365 patients who underwent surgery for primary GIST was included in the study. Using backward stepwise selection, sex, tumor size, tumor site, and mitotic rate were selected for incorporation into the nomogram. The nomogram demonstrated superior discrimination compared to the NIH criteria, modified NIH criteria, and Memorial Sloan-Kettering Nomogram and had similar discrimination to the Miettinen criteria (C-statistic 0.77 vs 0.73, 0.71, 0.71, and 0.78, respectively).

Conclusion

Four independent predictors of recurrence following surgery for primary GIST were used to create a nomogram to predict DFS. The nomogram stratified patients into prognostic groups and performed well on internal validation.

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Zusatzmaterial
ESM 1 (DOCX 23 kb)
11605_2014_2658_MOESM1_ESM.docx
ESM 2 (DOCX 21 kb)
11605_2014_2658_MOESM2_ESM.docx
Literatur
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