Background: Radical gastrectomy remains the main treatment for gastric cancer, despite its high mortality. A clinical predictive model of 90-day mortality (90DM) risk after gastric cancer surgery based on the Spanish EURECCA registry database was developed using a matching learning algorithm. We performed an external validation of this model based on data from an international multicenter cohort of patients. Methods: A cohort of patients from the European GASTRODATA database was selected. Demographic, clinical, and treatment variables in the original and validation cohorts were compared. The performance of the model was evaluated using the area under the curve (AUC) for a random forest model. Results: The validation cohort included 2546 patients from 24 European hospitals. The advanced clinical T- and N-category, neoadjuvant therapy, open procedures, total gastrectomy rates, and mean volume of the centers were significantly higher in the validation cohort. The 90DM rate was also higher in the validation cohort (5.6%) vs. the original cohort (3.7%). The AUC in the validation model was 0.716. Conclusion: The externally validated model for predicting the 90DM risk in gastric cancer patients undergoing gastrectomy with curative intent continues to be as useful as the original model in clinical practice.
背景：尽管胃癌根治性切除术死亡率较高，但其仍是胃癌的主要治疗手段。基于西班牙EURECCA注册数据库，我们运用匹配学习算法开发了胃癌术后90天死亡率（90DM）风险的临床预测模型。本研究基于国际多中心患者队列数据对该模型进行了外部验证。 方法：从欧洲GASTRODATA数据库中选取患者队列。比较原始队列与验证队列的人口统计学、临床及治疗相关变量。采用随机森林模型的曲线下面积（AUC）评估模型性能。 结果：验证队列包含来自24家欧洲医院的2546例患者。验证队列中临床T/N分期较晚、新辅助治疗比例、开放手术率、全胃切除率及医疗中心平均手术量均显著高于原始队列。验证队列的90DM率（5.6%）亦高于原始队列（3.7%）。验证模型的AUC值为0.716。 结论：针对接受根治性胃切除术的胃癌患者，该经过外部验证的90DM风险预测模型在临床实践中仍保持与原始模型相当的实用价值。
肿瘤(癌症)患者之家