PDF(Pubmed)
Abstract：
OBJECTIVE: Gastric cancer combined with multiple primary malignancies (GCM) is increasingly common. This study investigated GCM clinical features and survival time.
METHODS: Patients with GCM and GC only (GCO) were selected from the Surveillance, Epidemiology and End Results (SEER) database. Survival was compared between GCM and GCO groups using propensity score matching. Then, the GCM group was divided into a training cohort and a validation cohort. These cohorts were used to establish a nomogram for survival prediction in patients with GCM.
RESULTS: Survival time was significantly longer in the GCM group than in the GCO group. All-subsets regression was used to identify four variables for nomogram establishment: age, gastric cancer sequence, N stage, and surgery. The concordance index and time-dependent receiver operating characteristic curve indicated that the nomogram had favorable discriminative ability. Calibration plots of predicted and actual probabilities showed good consistency in both the training and validation cohorts. Decision curve analysis and risk stratification showed that the nomogram was clinically useful; it had favorable discriminative ability to recognize patients with different levels of risk.
CONCLUSIONS: Compared with GCO, GCM is a relatively indolent malignancy. The nomogram developed in this study can help clinicians to assess GCM prognosis.
METHODS: Patients with GCM and GC only (GCO) were selected from the Surveillance, Epidemiology and End Results (SEER) database. Survival was compared between GCM and GCO groups using propensity score matching. Then, the GCM group was divided into a training cohort and a validation cohort. These cohorts were used to establish a nomogram for survival prediction in patients with GCM.
RESULTS: Survival time was significantly longer in the GCM group than in the GCO group. All-subsets regression was used to identify four variables for nomogram establishment: age, gastric cancer sequence, N stage, and surgery. The concordance index and time-dependent receiver operating characteristic curve indicated that the nomogram had favorable discriminative ability. Calibration plots of predicted and actual probabilities showed good consistency in both the training and validation cohorts. Decision curve analysis and risk stratification showed that the nomogram was clinically useful; it had favorable discriminative ability to recognize patients with different levels of risk.
CONCLUSIONS: Compared with GCO, GCM is a relatively indolent malignancy. The nomogram developed in this study can help clinicians to assess GCM prognosis.
摘要：
目的：胃癌合并多原发恶性肿瘤（GCM）越来越常见。本研究调查了GCM的临床特征和生存时间。
方法：从监测中选择仅GCM和GC（GCO）的患者，流行病学和最终结果(SEER)数据库。使用倾向评分匹配比较GCM和GCO组之间的生存率。然后，GCM组分为训练队列和验证队列.这些队列用于建立GCM患者生存预测的列线图。
结果：GCM组的生存时间明显长于GCO组。所有子集回归用于确定列线图建立的四个变量：年龄，胃癌序列，N级,和手术。一致性指数和随时间变化的受试者工作特性曲线表明，列线图具有良好的判别能力。预测和实际概率的校准图在训练和验证队列中均显示出良好的一致性。决策曲线分析和风险分层表明，列线图在临床上有用；它具有良好的辨别能力，可以识别具有不同风险水平的患者。
结论：与GCO相比，GCM是一种相对惰性的恶性肿瘤。在这项研究中开发的列线图可以帮助临床医生评估GCM预后。
方法：从监测中选择仅GCM和GC（GCO）的患者，流行病学和最终结果(SEER)数据库。使用倾向评分匹配比较GCM和GCO组之间的生存率。然后，GCM组分为训练队列和验证队列.这些队列用于建立GCM患者生存预测的列线图。
结果：GCM组的生存时间明显长于GCO组。所有子集回归用于确定列线图建立的四个变量：年龄，胃癌序列，N级,和手术。一致性指数和随时间变化的受试者工作特性曲线表明，列线图具有良好的判别能力。预测和实际概率的校准图在训练和验证队列中均显示出良好的一致性。决策曲线分析和风险分层表明，列线图在临床上有用；它具有良好的辨别能力，可以识别具有不同风险水平的患者。
结论：与GCO相比，GCM是一种相对惰性的恶性肿瘤。在这项研究中开发的列线图可以帮助临床医生评估GCM预后。
