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Prognostic Tool May Benefit GI Cancer Patients

Nomogram accurately predicts cancer recurrence risk, may help guide treatment decisions

TUESDAY, Sept. 29 (HealthDay News) -- In patients who undergo surgery to remove primary gastrointestinal stromal tumors, a new computer-based tool called a nomogram accurately predicts the risk of cancer recurrence and may help clinicians determine which patients are candidates for adjuvant imatinib therapy, according to a study published online Sept. 29 in The Lancet Oncology.

Jason S. Gold, M.D., of Brigham and Womens Hospital in West Roxbury, Mass., and colleagues tested the nomogram in 212 patients from the Spanish Group for Research on Sarcomas and 148 patients from the Mayo Clinic in Rochester, Minn., and compared its predictive ability against three staging systems: the U.S. National Institutes of Health (NIH)-Fletcher, NIH-Miettinen, and the recently updated U.S. Armed Forces Institute of Pathology (AFIP)-Miettinen.

The researchers found that the nomogram had a significantly higher concordance probability than either of the NIH systems in the Spanish cohort (0.76 versus 0.70 and 0.66, respectively) and the American cohort (0.80 versus 0.74 and 0.78, respectively). They also found that the nomogram had a higher, but not statistically significant, concordance probability than the AFIP system.

"The ability to predict the likelihood of postoperative recurrence for any primary tumor treated by surgical resection is important for several reasons," the authors write. "First, patients can be counseled appropriately regarding their probable outcome. If effective adjuvant therapy exists, patients can be selected properly for postoperative treatment. Furthermore, physicians can identify the type (e.g., physical examination, blood tests, or radiological tests) and frequency of postoperative surveillance for tumor recurrence."

Several authors reported financial relationships with Novartis Pharmaceuticals.

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