To establish a nomogram to predict the probability of survival of patients with stage II/III gastric cancer (GC) who received incomplete peri-operative adjuvant chemotherapy (PAC). The medical records of stage II/III GC patients who received curative resection and 1 to 5 cycles of PAC from two tertiary hospitals were retrospectively reviewed. Patients were randomly classified into either a training group or validation group at a ratio of 7:3. The nomogram was constructed based on various prognostic factors using Cox regression analysis in the training cohort, and was validated by the validation group. Concordance index and calibration curves were used to evaluate the discrimination and calibration of the nomogram. Additionally, decision curve analysis (DCA) was used to compare the net clinical benefits of the nomogram and eighth version of TNM staging system. A total of 1,070 consecutive patients were included and 749 patients were enrolled into the training group. Lower body mass index (< 18.5 kg/m2), total gastrectomy, stage III disease and fewer cycles of PAC were identified to be independent predictors for poorer survival. The area under the curve (AUC) values of receiver operating characteristics (ROC) curve predicting 5-year survival probabilities and C-index were 0.768 and 0.742, 0.700 (95%CI: 0.674–0.726) and 0.689 (95%CI: 0.646–0.732) in the training and validation groups, respectively. The calibration curves in the validation cohort showed good agreement between the prediction and observation of 1-, 3- and 5-year survival probabilities. Furthermore, DCA showed that our model has a better net benefit than that of TNM staging system. The findings emphasize the value of completing PAC. The nomogram which was established to predict survival probability in patients with stage II/III GC receiving radical gastrectomy and incomplete PAC had good accuracy and was verified through both internal and external validation.

中文翻译：

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列线图预测接受根治性胃切除术和不完全围手术期辅助化疗的 II/III 期胃癌患者的总生存期：一项回顾性双中心队列研究

建立列线图来预测接受不完全围手术期辅助化疗 (PAC) 的 II/III 期胃癌 (GC) 患者的生存概率。回顾性分析两家三级医院接受根治性切除和1~5个周期PAC的II/III期GC患者的病历。患者按 7:3 的比例随机分为训练组或验证组。该列线图是根据训练队列中的各种预后因素使用 Cox 回归分析构建的，并由验证组进行了验证。使用一致性指数和校准曲线来评估列线图的辨别力和校准。此外，决策曲线分析 (DCA) 用于比较列线图和第八版 TNM 分期系统的净临床效益。总共纳入了 1,070 名连续患者，其中 749 名患者被纳入训练组。较低的体重指数（< 18.5 kg/m2）、全胃切除术、III期疾病和较少的 PAC 周期被认为是较差生存的独立预测因素。预测 5 年生存概率和 C 指数的受试者工作特征 (ROC) 曲线的曲线下面积 (AUC) 值分别为 0.768 和 0.742、0.700 (95%CI: 0.674–0.726) 和 0.689 (95%CI: 0.646) –0.732）分别在训练组和验证组中。验证队列中的校准曲线显示 1 年、3 年和 5 年生存概率的预测与观察之间具有良好的一致性。此外，DCA 表明我们的模型比 TNM 分期系统具有更好的净效益。研究结果强调了完成 PAC 的价值。为预测接受根治性胃切除术和不完全PAC的II/III期GC患者的生存概率而建立的列线图具有良好的准确性，并通过了内部和外部验证。