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

Abstract

Objectives \nTo construct a prognosis predictive nomogram for gastric cancer with peritoneal carcinomatosis treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. \n \n \nMethods \nThe 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. \n \n \nResults \n115 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. \n \n \nConclusions \nThe 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. \n \n \nKey words: \nStomach neoplasm;\xa0Neoplasm metastasis;\xa0Chemotherapy, regional perfusion;\xa0Prognosis