Estimating Survival Probabilities of Advanced Gastric Cancer Patients in the Second-Line Setting: The Gastric Life Nomogram.

Filippo Pietrantonio, Francesco Barretta, Valentina Fanotto, Se Hoon Park, Federica Morano, Giovanni Fucà, Monica Niger, Michele Prisciandaro, Nicola Silvestris, Francesca Bergamo, Lorenzo Fornaro, Roberto Bordonaro, Lorenza Rimassa, Daniele Santini, Gianluca Tomasello, Lorenzo Antonuzzo, Silvia Noventa, Antonio Avallone, Francesco Leone, Luca FaloppiSamantha Di Donato, Filippo de Braud, Jeeyun Lee, Ferdinando De Vita, Maria Di Bartolomeo, Rosalba Miceli, Giuseppe Aprile

Research output: Contribution to journalArticlepeer-review


We built and externally validated a nomogram for predicting the overall survival (OS) probability of advanced gastric cancer patients receiving second-line treatment. The nomogram was developed on a set of 320 Italian patients and validated on two independent sets (295 Italian and 172 Korean patients). Putative prognostic variables were selected using a random forest model and included in the multivariable Cox model. The nomogram's performance was evaluated by calibration plot and C index. ECOG performance status, neutrophils to lymphocytes ratio, and peritoneal involvement were selected and included into the multivariable model. The C index was 0.72 (95% CI 0.68-0.75) in the development set, 0.69 (95% CI 0.65-0.73) in the Italian validation set, but only 0.57 (95% CI 0.52-0.62) in the Korean set. While Italian calibrations were quite good, the Korean one was poor. Regarding 6-month OS predictions, calibration was best in both Caucasian cohorts and worst the in Asian one. Our nomogram may be a useful tool to predict 3- or 6-month OS in Caucasian gastric cancer patients eligible for second-line therapy. Based on three easy-to-collect variables, the Gastric Life nomogram may help clinicians improve patient selection for second-line treatments and assist in clinical trial enrollment.
Original languageUndefined/Unknown
Pages (from-to)344-352
Number of pages9
Publication statusPublished - 2018


  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Italy, epidemiology
  • Male
  • Middle Aged
  • Nomograms
  • Proportional Hazards Models
  • Republic of Korea, epidemiology
  • Stomach Neoplasms, mortality, pathology
  • Advanced gastric cancer
  • Prognosis
  • Stomach

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