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26.11.2018 | Original Article

Perioperative risk calculator for distal gastrectomy predicts overall survival in patients with gastric cancer

Zeitschrift:
Gastric Cancer
Autoren:
Masashi Takeuchi, Hirofumi Kawakubo, Shuhei Mayanagi, Yoshiyuki Suzuki, Koji Okabayashi, Toshiki Yamashita, Satoshi Kamiya, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Koichi Suda, Norihito Wada, Hiroya Takeuchi, Yuko Kitagawa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10120-018-0896-9) contains supplementary material, which is available to authorized users.

Abstract

Background

Although some predictive factors of long-term survival after a distal gastrectomy for gastric cancer have been reported, only few studies have predicted long-term outcomes based on preoperative parameters. We aimed to evaluate the reliability of perioperative risk calculator for predicting overall survival (OS) after distal gastrectomy in patients with gastric cancer.

Methods

Overall, 337 patients (225 males, 112 females) who had undergone a distal gastrectomy for gastric cancer at the Keio University Hospital, Tokyo, Japan, between January 2009 and December 2013 were enrolled in this study. We investigated the reliability of a risk calculator for the prediction of OS.

Results

In multivariate analysis, the risk models for operative mortality and 30-day mortality were identified as predictors of death. Time-dependent receiver operating characteristics (ROC) curve analysis indicated that the estimated area under the curve (AUC) value of the risk model for operative mortality was > 0.870 during the first postoperative 3 years. We set optimal cutoff values of the risk model operative mortality for OS using the Cutoff Finder online tool. The cutoff values of 4.117% were significant risk factors of death. Similar results were observed in the external validation set.

Conclusions

We elucidated the associations among risk calculator values and OS rates of patients with gastric cancer. Time-dependent ROC curve analysis suggested that the AUC value of the risk model for operative mortality was high, indicating that this risk calculator would be useful for not only short-term outcomes, but also long-term outcomes.

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Zusatzmaterial
Supplementary material 1 (DOCX 33 KB)
10120_2018_896_MOESM1_ESM.docx
Supplemental Figure 1: Time-dependent ROC operative mortality vs. 30-day mortality for DFS. The vertical axis indicates the estimated are under the ROC curve for disease-free survival at a particular time, and the horizontal axis indicates the month after surgery. Solid and broken lines indicate the estimated AUCs and 95% confidence intervals of each AUC, respectively. (EPS 818 KB)
10120_2018_896_MOESM2_ESM.eps
Supplemental Figure 2: Time-dependent ROC operative mortality vs. 30-day mortality for CSS. The vertical axis indicates the estimated are under the ROC curve for disease-free survival at a particular time, and the horizontal axis indicates the month after surgery. Solid and broken lines indicate the estimated AUCs and 95% confidence intervals of each AUC, respectively. (EPS 838 KB)
10120_2018_896_MOESM3_ESM.eps
Supplemental Figure 3: Kaplan–Meier curves of risk model for overall survival associated with the risk model for operative mortality in the external validation cohort. Blue lines and red lines indicate the group with risk model operative mortality values <4.117% and the risk model operative mortality values >4.117%, respectively. (EPS 224 KB)
10120_2018_896_MOESM4_ESM.eps
Literatur
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