• Johan L Dikken, Daniel G Coit, Raymond E Baser, Mithat Gönen, Karyn A Goodman, Murray F Brennan, Jansen Edwin P M EP Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands., Henk Boot, Cornelis J H van de Velde, Annemieke Cats, and Marcel Verheij.
• Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
• Int. J. Radiat. Oncol. Biol. Phys. 2014 Mar 1; 88 (3): 624-9.

PurposeThe internationally validated Memorial Sloan-Kettering Cancer Center (MSKCC) gastric carcinoma nomogram was based on patients who underwent curative (R0) gastrectomy, without any other therapy. The purpose of the current study was to assess the performance of this gastric cancer nomogram in patients who received chemoradiation therapy after an R0 resection for gastric cancer.Methods And MaterialsIn a combined dataset of 76 patients from the Netherlands Cancer Institute (NKI), and 63 patients from MSKCC, who received postoperative chemoradiation therapy (CRT) after an R0 gastrectomy, the nomogram was validated by means of the concordance index (CI) and a calibration plot.ResultsThe concordance index for the nomogram was 0.64, which was lower than the CI of the nomogram for patients who received no adjuvant therapy (0.80). In the calibration plot, observed survival was approximately 20% higher than the nomogram-predicted survival for patients receiving postoperative CRT.ConclusionsThe MSKCC gastric carcinoma nomogram significantly underpredicted survival for patients in the current study, suggesting an impact of postoperative CRT on survival in patients who underwent an R0 resection for gastric cancer, which has been demonstrated by randomized controlled trials. This analysis stresses the need for updating nomograms with the incorporation of multimodal strategies.Copyright © 2014 Elsevier Inc. All rights reserved.

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