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Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis
The Lancet Oncology - Online First, 10/01/09

Gold JS et al. – The nomogram accurately predicts RFS after resection of localised primary GIST and could be used to select patients for adjuvant imatinib therapy.

• 127 patients
• Nomogram to predict RFS based on tumour size (cm), location (stomach, small intestine, colon/rectum, or other), and mitotic index developed
• Nomogram was tested in patients from the Spanish Group for Research on Sarcomas (GEIS; n=212) and the Mayo Clinic, Rochester, MN, USA (Mayo; n=148)
• Nomogram assessed by calculating concordance probabilities and testing calibration of predicted RFS with observed RFS
• Concordance probabilities also compared with those of three commonly used staging systems

• Nomogram had a concordance probability of 0·78 (SE 0·02) in the MSKCC dataset, and 0·76 (0·03) and 0·80 (0·02) in validation cohorts
• Nomogram predictions well calibrated
• Inclusion of tyrosine kinase mutation status in nomogram did not improve its discriminatory ability
• Concordance probabilities of nomogram were better than those of the two NIH staging systems (0·76 [0·03] vs 0·70 and 0·66 in the GEIS validation cohort; 0·80 [0·02] vs 0·74 [0·02, p=0·04] and 0·78 [0·02, p=0·05] in the Mayo cohort) and similar to those of the AFIP-Miettinen staging system (0·76 [0·03] vs 0·73 [0·004, p=0·28] in the GEIS cohort; 0·80 [0·02] vs 0·76 [0·003, p=0·09] in the Mayo cohort) Nomogra
• Nomogram predictions of RFS seemed better calibrated than predictions made with AFIP-Miettinen system

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