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Zhang S, Zheng L, Zhang Y, Gao Y, Liu L, Jiang Z, Wang L, Ma Z, Wu J, Chen J, Lu Y, Wang D. A web-based prediction model for long-term cancer-specific survival of middle-aged patients with early-stage gastric cancer: a multi-institutional retrospective study. J Cancer Res Clin Oncol 2023; 149:16551-16561. [PMID: 37712958 DOI: 10.1007/s00432-023-05405-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND This study constructed and validated a prognostic model to evaluate long-term cancer-specific survival (CSS) in middle-aged patients with early gastric cancer (EGC). METHODS We extracted clinicopathological data from relevant patients between 2004 and 2015 from Surveillance, Epidemiology, and End Results (SEER) database, and randomly divided the patients into a training group (N = 688) and a validation group (N = 292). In addition, 102 Chinese patients were enrolled for external validation. Univariate and multivariate Cox regression models were used to screen for independent prognostic factors, and a nomogram was constructed to predict CSS. We used the concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) to evaluate the predictive performance of the model. RESULTS Univariate and multivariate COX regression analyses showed that tumor location, differentiation grade, N stage, chemotherapy, and number of regional nodes examined were independent risk factors for prognosis, and these factors were used to construct the nomogram. The C-index of the model in the training cohort, internal validation cohort, and external validation cohort was 0.749 (95% CI 0.699-0.798), 0.744 (95% CI 0.671-0.818), and 0.807 (95% CI 0.721-0.893), respectively. The calibration curve showed that the model had an excellent fit. The DCA curve showed that the model had good predictive performance and practical clinical value. CONCLUSION This study developed and validated a new nomogram to predict CSS in middle-aged patients with EGC. The prediction model has unique and practical value and can help doctors carry out individualized treatment and judge prognosis.
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Affiliation(s)
- Simeng Zhang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Longbo Zheng
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266400, Shandong, China
| | - Yuxia Zhang
- Department of Rehabilitation Pain, Shanghe County People's Hospital, Jinan, Shandong, China
| | - Yuan Gao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266400, Shandong, China
| | - Lei Liu
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Zinian Jiang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Liang Wang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Zheng Ma
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Jinhui Wu
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Jiansheng Chen
- Department of Gastrointestinal Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Yun Lu
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266400, Shandong, China
| | - Dongsheng Wang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China.
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266400, Shandong, China.
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