Ann Clin Nutr Metab.
2022 Dec;14(2):55-65. 10.15747/ACNM.2022.14.2.55.
Development and Internal/External Validation of a Prediction Model for Weight Loss Following Gastric Cancer Surgery: A Multicenter Retrospective Study
- Park JH
1,2 - Kong SH1,3
- Park DJ1,3
- Yang HK1,3
- Kim JW4
- Park KB5
- Cho I6
- Hwang SH7
- Kim DW8
- Kim SM9
- Ryu SW10
- Gong SC11
- Jung PY11
- Ryu H11
- Kim SG12
- Choi CI13
- Kim DH13
- Choi SI14
- Park JH15
- Park DJ16
- Kim GY16
- Choi Y17
- Lee HJ1,3
- Affiliations
-
- 1Department of Surgery, Seoul National University Hospital, Seoul, Korea
- 2Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
- 3Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- 4Department of Surgery, Chung-Ang University Hospital, Seoul, Korea
- 5Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 6Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- 7Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- 8Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
- 9Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- 10Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
- 11Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- 12Department of Surgery, The Catholic University of Korea Yeouido St. Mary’s Hospital, Seoul, Korea
- 13Department of Surgery, Pusan National University College of Medicine, Busan, Korea
- 14Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- 15Department of Surgery, Gyeongsang National University College of Medicine, Jinju, Korea
- 16Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- 17Department of Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
- KMID: 2536435
- DOI: http://doi.org/10.15747/ACNM.2022.14.2.55
Abstract
- Purpose
To develop an individualized model for predicting the extent of unintentional weight loss following gastrectomy in patients with gastric cancer based on related risk factors and to externally validate this model using multicenter clinical data in Korea.
Materials and Methods
Among gastric cancer patients who underwent curative gastrectomy at 14 different gastric cancer centers, clinical data from patients with more than one weight measurement during the three-year followup period were retrospectively collected. Risk factors associated with weight loss in gastric cancer patients after gastrectomy were analyzed, and a predictive model was developed. Internal and external validation were performed.
Results
The data from 2,649 patients were divided into a derivation set (n=1,420 from Seoul National University Hospital) and validation set (n=1,229 from 13 different gastric cancers). Postoperative duration (six vs. 12, 24, or 36 months), sex (female vs. male), age, preoperative body mass index, type of surgery (pylorus-preserving vs. total, distal or proximal gastrectomy), and cancer stage (I vs. II or III) were included in the final prediction model. The model showed approximately 20% accuracy in predicting weight loss at each period: R2 at six, 12, 24 and 36 months after gastrectomy in internal validation=0.20, 0.21, 0.17, and 0.18, respectively, and in external validation=0.20, 0.22, 0.18, and 0.18, respectively. Calibration slopes of internal and external validation were 0.95 and 1.0, respectively.
Conclusion
Although predictive accuracy of the model did not reach an acceptable level, repeated external validation measurements showed high reliability. The model may serve as a basic reference in clinical practice.
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