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Article

A Nomogram Predicting Progression Free Survival in Patients with Gastrointestinal Stromal Tumor Receiving Sunitinib: Incorporating Pre-Treatment and Post-Treatment Parameters

1
Department of Surgery and GIST Team, Chang Gung Memorial Hospital at Linkou, ChangGung University College of Medicine, Taoyuan 33305, Taiwan
2
Division of Hematology-Oncology, Department of Internal Medicine and GIST Team, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Daruka Mahadevan
Cancers 2021, 13(11), 2587; https://doi.org/10.3390/cancers13112587
Received: 4 May 2021 / Revised: 12 May 2021 / Accepted: 20 May 2021 / Published: 25 May 2021
Sunitinib has been approved as the second-line targeted treatment for gastrointestinal stromal tumor (GIST) after imatinib failure. It is thus necessary to effectively assess prognosis after sunitinib use. However, the current assessment remains insufficient for the contemporary period. We examined prognostic factors influencing progression-free survival. Furthermore, we constructed a prognostic nomogram model using these significant pre-treatment and post-treatment variables.
The present study aimed to construct a prognostic nomogram incorporating pre-treatment and post-treatment factors to predict progression-free survival (PFS) after use of sunitinib in patients with metastatic gastrointestinal stromal tumors (GISTs) following imatinib intolerance or failure. From 2007 to 2018, 109 metastatic GIST patients receiving sunitinib at Chang Gung Memorial Hospital, Taiwan, were enrolled. A prognostic nomogram to predict PFS was developed. Sixty-three male and forty-six female metastatic GIST patients, with a median age of 61 years (range: 15–91 years), received sunitinib. The median PFS for 109 patients is 9.93 months. For pre-treatment factors, male gender, body mass index more than 18.5 kg/m2, no sarcopenia status, higher lymphocyte count, lower platelet/lymphocyte ratio, good performance status, higher sunitinib dose, and non-liver metastasis were significantly associated with favorable PFS. For post-treatment factors, adverse events with hypertension, hand–foot skin reaction, and diarrhea were significantly associated with favorable PFS. However, only eight clinicopathological independent factors for PFS prediction were selected for prognostic nomogram establishment. The calibration curve for probability of PFS revealed good agreement between the nomogram prediction and actual observation. High risk patients will experience the lowest PFS. A prognostic nomogram integrating eight clinicopathological factors was constructed to assist prognostic prediction for individual patients with advanced GIST after sunitinib use. View Full-Text
Keywords: sunitinib; gastrointestinal stromal tumor; prognostic nomogram model; KIT genotype; hypertension; hand–foot skin reaction; survival sunitinib; gastrointestinal stromal tumor; prognostic nomogram model; KIT genotype; hypertension; hand–foot skin reaction; survival
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MDPI and ACS Style

Chang, Y.-R.; Huang, W.-K.; Wang, S.-Y.; Wu, C.-E.; Chen, J.-S.; Yeh, C.-N. A Nomogram Predicting Progression Free Survival in Patients with Gastrointestinal Stromal Tumor Receiving Sunitinib: Incorporating Pre-Treatment and Post-Treatment Parameters. Cancers 2021, 13, 2587. https://doi.org/10.3390/cancers13112587

AMA Style

Chang Y-R, Huang W-K, Wang S-Y, Wu C-E, Chen J-S, Yeh C-N. A Nomogram Predicting Progression Free Survival in Patients with Gastrointestinal Stromal Tumor Receiving Sunitinib: Incorporating Pre-Treatment and Post-Treatment Parameters. Cancers. 2021; 13(11):2587. https://doi.org/10.3390/cancers13112587

Chicago/Turabian Style

Chang, Yau-Ren, Wen-Kuan Huang, Shang-Yu Wang, Chiao-En Wu, Jen-Shi Chen, and Chun-Nan Yeh. 2021. "A Nomogram Predicting Progression Free Survival in Patients with Gastrointestinal Stromal Tumor Receiving Sunitinib: Incorporating Pre-Treatment and Post-Treatment Parameters" Cancers 13, no. 11: 2587. https://doi.org/10.3390/cancers13112587

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