Nomogram based on systemic inflammatory response markers predicting the survival of patients with resectable gastric cancer after D2 gastrectomy

Abstract

This study aimed to construct a nomogram to predict survival of patients with resectable gastric cancer (RGC) based on both clinicopathology characteristics and systemic inflammatory response markers (SIRMs). Of 3,452 RGC patients after D2 gastrectomy at the Sun Yat-sen University Cancer Center, 1058 patients who met the inclusion criterion were analyzed. The patients operated on from January 1, 2005 to December 31, 2009 were assigned to the training set (817 patients) to establish a nomogram, and the rest (241 patients) were selected as validation set. Based on the training set, seven independent risk factors were selected in the nomogram. The calibration curves for probability of 1-year, 3-year and 5-year overall survival (OS) showed satisfactory accordance between nomogram prediction and actual observation. When the metastatic lymph node stage (mLNS) is replaced by metastasis lymph node ratio (mLNR) in validation set, the C-index in predicting OS rise from 0.77 to 0.79, higher than that of 7th American Joint Committee on Cancer 7th (AJCC) staging system (0.70; p<0.001). In conclusions, the proposed nomogram which including mLNR and routine detected SIRMs resulted in optimal survival prediction for RGC patients after D2 gastrectomy.