Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas
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ORIGINAL ARTICLE
Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non‑Hodgkin Lymphomas Bo Sun1 · Yang Xia1 · Yuqian Guo1 · Chiyi He1 · Wei Wang1 Received: 4 June 2019 / Accepted: 13 January 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background and Aims The objective of this study was to construct and authenticate nomograms to project overall survival (OS) and cancer-specific survival (CSS) in primary gastrointestinal non-Hodgkin lymphomas (PGINHL). Methods Suitable patients were chosen from the Surveillance, Epidemiology and End Results database and Wannan Medical College Yijishan Hospital. The Cox regression model was used to acquire independent predictive factors to develop nomograms for projecting OS and CSS. The performance of the nomograms was validated using the Harrell’s concordance index (C-index), calibration curves, and decision curve analysis (DCA) and was compared with that of the AJCC 7th staging system. Survival curves were obtained using the Kaplan–Meier method, while the log-rank test was used to compare the difference among the groups. Results The C-index of the nomograms for OS and CSS was 0.735 (95% CI = 0.719–0.751) and 0.761 (95% CI = 0.739– 0.783), respectively, signifying substantial predictive accuracy. These outcomes were reproducible when the nomograms were used for the internal and external validation cohorts. Moreover, assessments of the C-index, AUC, and DCA between the nomogram results and the AJCC 7th staging system showed that the former was better for evaluation and was more clinically useful. Conclusions We constructed the nomogram which could predict 1-, 3-, and 5-year OS and CSS of patients with PGINHL. Our nomogram showed good performance, suggesting that it can be used as an efficacious instrument for predictive assessment of patients with PGINHL. Keywords Primary gastrointestinal non-Hodgkin lymphomas · Nomogram · Overall survival · Cancer-specific survival
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06078-9) contains supplementary material, which is available to authorized users. * Wei Wang [email protected] Bo Sun [email protected] Yang Xia [email protected] Yuqian Guo [email protected] Chiyi He [email protected] 1
Department of Gastroenterology, Yijishan Hospital, Wannan Medical College, No. 2 West of Zheshan Road, Wuhu 241000, Anhui Province, China
During the past decade, the incidence of primary gastrointestinal non-Hodgkin lymphomas (PGINHL) has been increasing, with an estimated incidence of 2.7 per 100,000 in a North American population [1]. PGINHL is a malignant tumor that originates in the lamina propria of the mucosa and submucosa of the gastrointestinal tract, accounting for 2–7% of malignant tumors of the gastrointestinal tract [2]. The stomach is the most affected site, followed by the colon and small intestine. The main pathological subtype is diffuse large B cell lymphoma (DLBCL). A
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