Development and Validation of a Nomogram Predicting the Overall Survival of Gastric Cancer Patients Received Neoadjuvant Chemotherapy

Background: Neoadjuvant chemotherapy is now widely used in gastric cancer patients, while tools available to predict the prognosis are limited. In this study, we aim to develop and validate a nomogram that predicts overall survival in gastric cancer patients received neoadjuvant chemotherapy.Methods: From 01, 2007 to 12, 2014, 471 patients underwent neoadjuvant chemotherapy and received gastrectomy with D2 lymph nodes dissection at Peking University Cancer Hospital in Beijing, China. We developed a nomogram based on the Cox proportional hazard model and conducted external validation using a cohort of 239 patients at Sun Yat-sen University Cancer Center.Findings: The OS rate at 1 year and 3 years were 90.0% and 64.1%, respectively. Body Mass Index (BMI) category, tumor location, T stage and N stage were independent prognostic factors for the survival outcome. The C-index of the model was 0.74 in the development cohort and 0.69 in the validation cohort. Our nomogram also showed good calibration for both cohorts.Interpretation: We developed and validated a nomogram to predict the 1 and 3-year OS of patients who received neoadjuvant chemotherapy and radical gastrectomy with D2 lymph node dissection. This nomogram uses readily available clinicopathologic factors and predicts survival more accurately than the AJCC TNM staging system, which is the current golden standard.