Postoperative nomogram for survival of patients with retroperitoneal sarcoma treated with curative intent

作者：Anaya D A; Lahat G; Wang X; Xiao L; Pisters P W; Cormier J N; Hunt K K; Feig W; Lev D C; Pollock R E^*

来源：Annals of Oncology, 2010, 21(2): 397-402.

DOI：10.1093/annonc/mdp298

• postoperative nomogram
• prognosis
• retroperitoneal sarcoma
• staging

Background: Current American Joint Committee on Cancer retroperitoneal sarcoma (RPS) staging is not representative of patients with RPS specifically and has limited discriminative power. Our objective was to develop a RPS disease-specific nomogram capable of stratifying patients based on probability of overall survival (OS) after resection.
Patients and methods: In all, 1118 RPS patients were evaluated at our institution (1996-2006). Patients with resectable, nonmetastatic disease were selected (n = 343) and baseline, treatment and outcome variables were retrieved. A nomogram was created and its performance was evaluated by calculating its discrimination (concordance index) and calibration and by subsequent internal validation.
Results: Median follow-up and OS were 50 and 59 months, respectively. Independent predictors of OS were included in the nomogram: age (>= 65), tumor size (>= 15 cm), type of presentation (primary versus recurrent), multifocality, completeness of resection and histology. The concordance index was 0.73 [95% confidence interval (CI) 0.71-0.75] and the calibration was excellent, with all observed outcomes within the 95% CI of each predicted survival probability.
Conclusions: A RPS-specific postoperative nomogram was developed. It improves RPS staging by allowing a more dynamic and robust disease-specific risk stratification. This prognostic tool can help in patient counseling and for selection of high-risk patients that may benefit from adjuvant therapies or inclusion into clinical trials.

• 出版日期2010-2