Han et al developed a nomogram for precting long-term survival for a patient undergoing a D2 gastrectomy for gastric carcinoma. This can help to identify a patient who may benefit from more aggressive management. The authors are from Seoul National University and Cancer Institute Ariake Hospital in Tokyo.
Patient selection: gastric carcinoma treated with a D2 gastrectomy (gastrectomy with D2 lymphadenectomy)
Parameters:
(1) age in years
(2) gender
(3) depth of invasion
(4) location in stomach
(5) number of lymph nodes with metastases
(6) number of lymph nodes recovered and identified (minimum 10)
|
Parameter |
Finding |
Points |
|
age in years |
< 40 years of age |
6.9 |
|
|
40 to 49 years of age |
0 |
|
|
50 to 59 years of age |
10.8 |
|
|
60 to 69 years of age |
28.5 |
|
|
>= 70 years of age |
47.9 |
|
gender |
female |
0 |
|
|
male |
11.5 |
|
depth of invasion |
mucosa |
0 |
|
|
submucosa |
11.5 |
|
|
muscularis propria |
23.3 |
|
|
subserosa |
50 |
|
|
serosa |
60.8 |
|
|
invasion of adjacent organs |
100 |
|
location in stomach |
lower |
0 |
|
|
middle |
5.3 |
|
|
upper |
14.6 |
|
number of nodal metastases |
0 |
0 |
|
|
1 or 2 |
12,5 |
|
|
3 to 6 |
36.1 |
|
|
7 to 15 |
59 |
|
|
>= 16 |
86.8 |
points for number of lymph nodes examined =
= MIN(37.2,MAX(0, (0.00156 * ((nodes)^2)) - (0.5229 * (nodes)) + 41.08))
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 298
• The higher the score the worse the survival.
|
Total Score |
Percent of Patients with 10-Year Overall Survival |
|
< 7 |
> 95% |
|
7 to 166 |
(-0.002472 * ((points)^2)) + (0.02069 * (points)) + 94.61 |
|
166 to 233 |
(0.005456 * ((points)^2)) - (2.61 * (points)) + 313 |
|
> 233 |
< 1% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
