Perioperative risk calculator for distal gastrectomy predicts overall survival in patients with gastric cancer

摘要

BackgroundAlthough some predictive factors of long-term survival after a distal gastrectomy for gastric cancer have been reported, only few studies have predicted long-term outcomes based on preoperative parameters. We aimed to evaluate the reliability of perioperative risk calculator for predicting overall survival (OS) after distal gastrectomy in patients with gastric cancer.MethodsOverall, 337 patients (225 males, 112 females) who had undergone a distal gastrectomy for gastric cancer at the Keio University Hospital, Tokyo, Japan, between January 2009 and December 2013 were enrolled in this study. We investigated the reliability of a risk calculator for the prediction of OS.ResultsIn multivariate analysis, the risk models for operative mortality and 30-day mortality were identified as predictors of death. Time-dependent receiver operating characteristics (ROC) curve analysis indicated that the estimated area under the curve (AUC) value of the risk model for operative mortality was >0.870 during the first postoperative 3years. We set optimal cutoff values of the risk model operative mortality for OS using the Cutoff Finder online tool. The cutoff values of 4.117% were significant risk factors of death. Similar results were observed in the external validation set.ConclusionsWe elucidated the associations among risk calculator values and OS rates of patients with gastric cancer. Time-dependent ROC curve analysis suggested that the AUC value of the risk model for operative mortality was high, indicating that this risk calculator would be useful for not only short-term outcomes, but also long-term outcomes.