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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The original data supporting the conclusion of this paper will be provided by the authors.
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Funding
The study was supported by the Beijing Bethune Physician Research Foundation (Grant No. 05006).
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DSW: conceptualization. YG, YXZ, LW, ZNJ, ZM, LL, JSC, and JHW: data curation, methodology, and software. SMZ: writing—original draft. YL and DSW: supervision. LBZ, YL, and DSW: writing—review and editing.
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Zhang, S., Zheng, L., Zhang, Y. et al. 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 149, 16551–16561 (2023). https://doi.org/10.1007/s00432-023-05405-7
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DOI: https://doi.org/10.1007/s00432-023-05405-7