Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort

Abstract Background After the standardization, recording and follow‐up of imatinib use that significantly prolongs survival of gastrointestinal stromal tumors (GISTs), a comprehensive reassessment of the prognosis of GISTs is necessary and more conductive to treatment options. Methods A total of 218...

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Main Authors: Shu Wang, Yuhao Wang, Jialin Luo, Haoyuan Wang, Yan Zhao, Yongzhan Nie, Jianjun Yang
Format: Article
Language:English
Published: Wiley 2023-08-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.6240
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author Shu Wang
Yuhao Wang
Jialin Luo
Haoyuan Wang
Yan Zhao
Yongzhan Nie
Jianjun Yang
author_facet Shu Wang
Yuhao Wang
Jialin Luo
Haoyuan Wang
Yan Zhao
Yongzhan Nie
Jianjun Yang
author_sort Shu Wang
collection DOAJ
description Abstract Background After the standardization, recording and follow‐up of imatinib use that significantly prolongs survival of gastrointestinal stromal tumors (GISTs), a comprehensive reassessment of the prognosis of GISTs is necessary and more conductive to treatment options. Methods A total of 2185 GISTs between 2013 and 2016 were obtained from the Surveillance, Epidemiology, and End Results database and comprised our training (n = 1456) and internal validation cohorts (n = 729). The risk factors extracted from univariate and multivariate analyses were used to establish a predictive nomogram. The model was evaluated and tested in the validation cohort internally and in 159 patients with GIST diagnosed between January 2015 and June 2017 in Xijing Hospital externally. Results The median OS was 49 months (range, 0–83 months) in the training cohort and 51 months (0–83 months) in the validation cohort. The concordance index (C‐index) of the nomogram was 0.777 (95% CI, 0.752–0.802) and 0.7787 (0.7785, bootstrap corrected) in training and internal validation cohorts, respectively, and 0.7613 (0.7579, bootstrap corrected) in the external validation cohort. Receiver operating characteristic curves and calibration curves for 1‐, 3‐, and 5‐year overall survival (OS) showed a high degree of discrimination and calibration. The area under the curve showed that the new model performed better than the TNM staging system. In addition, the model could be dynamically visualized on a webpage. Conclusion We developed a comprehensive survival prediction model for assessing the 1‐, 3‐ and 5‐year OS of patients with GIST in the postimatinib era. This predictive model outperforms the traditional TNM staging system and sheds light on the improvement of the prognostic prediction and the selection of treatment strategies for GISTs.
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spelling doaj.art-f4bbe968a50141cc8ba402a1ac92bd0e2024-01-09T05:41:08ZengWileyCancer Medicine2045-76342023-08-011215159701598210.1002/cam4.6240Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohortShu Wang0Yuhao Wang1Jialin Luo2Haoyuan Wang3Yan Zhao4Yongzhan Nie5Jianjun Yang6Department of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaDepartment of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaDepartment of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaDepartment of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaDepartment of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaState Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases The Fourth Military Medical University Xi'an ChinaDepartment of Digestive Surgery Xi Jing Hospital, The Fourth Military Medical University Xi'an ChinaAbstract Background After the standardization, recording and follow‐up of imatinib use that significantly prolongs survival of gastrointestinal stromal tumors (GISTs), a comprehensive reassessment of the prognosis of GISTs is necessary and more conductive to treatment options. Methods A total of 2185 GISTs between 2013 and 2016 were obtained from the Surveillance, Epidemiology, and End Results database and comprised our training (n = 1456) and internal validation cohorts (n = 729). The risk factors extracted from univariate and multivariate analyses were used to establish a predictive nomogram. The model was evaluated and tested in the validation cohort internally and in 159 patients with GIST diagnosed between January 2015 and June 2017 in Xijing Hospital externally. Results The median OS was 49 months (range, 0–83 months) in the training cohort and 51 months (0–83 months) in the validation cohort. The concordance index (C‐index) of the nomogram was 0.777 (95% CI, 0.752–0.802) and 0.7787 (0.7785, bootstrap corrected) in training and internal validation cohorts, respectively, and 0.7613 (0.7579, bootstrap corrected) in the external validation cohort. Receiver operating characteristic curves and calibration curves for 1‐, 3‐, and 5‐year overall survival (OS) showed a high degree of discrimination and calibration. The area under the curve showed that the new model performed better than the TNM staging system. In addition, the model could be dynamically visualized on a webpage. Conclusion We developed a comprehensive survival prediction model for assessing the 1‐, 3‐ and 5‐year OS of patients with GIST in the postimatinib era. This predictive model outperforms the traditional TNM staging system and sheds light on the improvement of the prognostic prediction and the selection of treatment strategies for GISTs.https://doi.org/10.1002/cam4.6240gastrointestinal stromal tumornomogramprognostic factorsSEER analyses
spellingShingle Shu Wang
Yuhao Wang
Jialin Luo
Haoyuan Wang
Yan Zhao
Yongzhan Nie
Jianjun Yang
Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
Cancer Medicine
gastrointestinal stromal tumor
nomogram
prognostic factors
SEER analyses
title Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
title_full Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
title_fullStr Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
title_full_unstemmed Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
title_short Development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era: A study based on the SEER database and a Chinese cohort
title_sort development and validation of a prognostic nomogram for gastrointestinal stromal tumors in the postimatinib era a study based on the seer database and a chinese cohort
topic gastrointestinal stromal tumor
nomogram
prognostic factors
SEER analyses
url https://doi.org/10.1002/cam4.6240
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