Utility of a prognostic nomogram designed for gastric cancer in predicting outcome of patients with R0 resected duodenal adenocarcinoma Journal Article


Authors: Gold, J. S.; Tang, L. H.; Gonen, M.; Coit, D. G.; Brennan, M. F.; Allen, P. J.
Article Title: Utility of a prognostic nomogram designed for gastric cancer in predicting outcome of patients with R0 resected duodenal adenocarcinoma
Abstract: Background: There is little information to determine prognosis or to guide clinical care for patients with duodenal adenocarcinoma. We have hypothesized that survival following resection of duodenal cancer is similar to survival following resection of distal gastric cancer. We tested the utility of a nomogram created for determining disease-specific survival (DSS) after R0 resection of gastric cancer in estimating DSS for patients with resected duodenal cancer. Methods: Review of a prospective database identified 106 patients who underwent R0 resection of duodenal cancer. Comparison was made to 459 patients with distal gastric cancer. The Student t test, Fisher exact test, Pearson chi-square test, and log-rank test were used to assess statistical significance. Concordance probabilities and calibration plots were used for nomogram validation. Results: Duodenal cancers were more deeply invasive than gastric cancer (P < .01). The rate of lymph node positivity was not statistically different between the two tumors; however, there were differences in the rate of nodal positivity for certain depths of penetration. Younger age (P = .002), negative regional lymph nodes (P = .03), and tumors confined to the bowel wall or subserosa (P = .03) were associated with improved DSS for duodenal cancer. When applied to patients with duodenal cancer, the nomogram had a concordance probability of 0.70, and calibration appeared to be accurate. Conclusions: A nomogram created for determining DSS after resection of gastric cancer predicts outcome for duodenal cancer patients and may prove to be useful for research and in guiding clinical care. © 2007 Society of Surgical Oncology.
Keywords: survival; adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; major clinical study; histopathology; validation process; lymph nodes; lymphatic metastasis; neoplasm staging; prospective study; prospective studies; pancreaticoduodenectomy; adenocarcinoma; calibration; risk factors; data base; correlation coefficient; statistical significance; probability; nomograms; models, statistical; lymph node; surgery; stomach cancer; neoplasm invasiveness; age distribution; chi square test; stomach neoplasms; fisher exact test; nomogram; student t test; gastric cancer; log rank test; duodenum cancer; duodenal cancer; duodenal neoplasms
Journal Title: Annals of Surgical Oncology
Volume: 14
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2007-11-01
Start Page: 3159
End Page: 3167
Language: English
DOI: 10.1245/s10434-007-9542-1
PUBMED: 17680313
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 5" - "Export Date: 17 November 2011" - "CODEN: ASONF" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Murray F Brennan
    817 Brennan
  2. Mithat Gonen
    734 Gonen
  3. Peter Allen
    460 Allen
  4. Laura Hong Tang
    338 Tang
  5. Daniel Coit
    433 Coit