Construction and evaluation of prognosis predictive nomogram for gastric cancer with peritoneal carcinomatosis treated by cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy

中华普通外科杂志 Pub Date : 2019-10-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.10.003

Z. Ji, Yang Yu, Gang Liu, Yanbin Zhang, Bing Li, S. An, Xinbao Li, Yan Li

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Abstract

Objectives To construct a prognosis predictive nomogram for gastric cancer with peritoneal carcinomatosis treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Methods The clinical data and follow-up results of gastric cancer with peritoneal carcinomatosis patients treated by cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy at our center from 2005 to 2017 were collected for log-rank test and multivariate COX proportional regression model analysis. A prognostic predictive nomogram was constructed and internally validated. Results 115 patients were included. The median overall survival was 13.1 months, and 1-, 2-, 3-, and 5-year survival rates being 56.5%, 25.3%, 12.6%, and 8.1% respectively. Univariate and the following multivariate analysis identified completeness of cytoreduction, temperature of hyperthermic intraperitoneal chemotherapy and type of adjuvant chemotherapy as independent prognostic factors on overall survival. The nomogram using these three factors showed a concordance index of 0.721 (95% CI: 0.669-0.773). The calibration curves for 1-, 2- and 3 -year survival probability showed a good consistency between actual observation and prediction. Conclusions The nomogram based on completeness of cytoreduction, temperature of hyperthermic intraperitoneal chemotherapy and type of adjuvant chemotherapy can effectively predict the survival probability for gastric cancer with peritoneal carcinomatosis patients treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Key words: Stomach neoplasm; Neoplasm metastasis; Chemotherapy, regional perfusion; Prognosis

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细胞减灭术加腹腔热疗治疗癌症腹膜癌预后预测列线图的构建与评价

目的构建细胞减灭术联合腹腔热疗治疗癌症腹膜癌的预后预测列线图。方法收集我中心2005-2017年收治的癌症合并腹膜癌患者行细胞减灭术加腹腔热疗治疗的临床资料和随访结果，进行log-rank检验和多变量COX比例回归模型分析。构建了预后预测列线图，并进行了内部验证。结果纳入115例患者。中位总生存期为13.1个月，1、2、3和5年生存率分别为56.5%、25.3%、12.6%和8.1%。单变量和以下多变量分析确定细胞减少的完整性、腹腔内高温化疗的温度和辅助化疗的类型是影响总生存率的独立预后因素。使用这三个因素的列线图显示出0.721的一致性指数（95%可信区间：0.669-0.773）。1年、2年和3年生存概率的校准曲线显示出实际观察和预测之间的良好一致性。结论以细胞减灭完全性、腹腔热疗温度和辅助化疗类型为基础的列线图能有效预测癌症腹膜癌患者行细胞减灭术加腹腔热疗治疗的生存概率。关键词：胃肿瘤；肿瘤转移；化疗，局部灌注；预后

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中华普通外科杂志

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