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A Novel Nomogram Integrated with Inflammation-Based Factors to Predict the Prognosis of Gastric Cancer Patients

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Abstract

Introduction

Gastric cancer (GC) is the fifth most common cancer worldwide, and every year approximately 950,000 individuals are diagnosed worldwide. Our study aimed to establish an effective nomogram to predict the prognosis of GC based on inflammation biomarkers.

Methods

We retrospectively analysed GC patients from the Sun Yat-sen University Cancer Center. The nomogram was developed with a primary cohort (n = 1067), and 537 patients were included in the validation cohort. The univariate survival analyses included 19 biomarkers.

Results

The multivariate analysis showed that tumour stage, metastasis stage and C-reactive protein (CRP), albumin (ALB), carcinoembryonic antigen (CEA) and carbohydrate antigen-199 (CA199) levels as well as the lymphocyte (LYM) count were independent risk factors for the prognosis of GC patients. The nomogram was based on the above factors. In the primary cohort, the nomogram had a concordance index (C-index) of 0.825 (95% CI 0.796–0.854), which was higher than the C-index of the AJCC TNM stage and that of the other biomarkers (CEA and CA199). The calibration plot suggested good agreement between the actual and nomogram-predicted overall survival (OS) probabilities, and the decision curve analyses showed that the nomogram model had a higher overall net benefit in predicting OS than the AJCC TNM stage. Moreover, we divided the patients into the following three distinct risk groups for OS based on the nomogram points: low, middle and high risk. The differences in OS rates were significant among the subgroups (P < 0.001).

Conclusion

A novel nomogram integrated with inflammatory prognostic factors was proposed, which is highly predictive of OS in GC patients.

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Acknowledgements

We thank the staff of the biochemical laboratory of Sun Yat-sen University Cancer Center, who provided various biochemical markers, and all of the staff who supported our study.

Funding

The authors received no financial support for the research, authorship and/or publication of this article. The journal’s Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

All named authors (Xueping Wang, Minjie Mao, Shihao Zhu, Shan Xing, Yiling Song, Lin Zhang and Peidong Chi) have nothing to disclose.

Compliance with Ethics Guidelines

The Institute Research Ethics Committee of the Sun Yat-Sen University Cancer Center, Guangzhou, China, approved this study. All patients provided written informed consent.

Data Availability

The analyzed data sets generated during the study are available from the corresponding author on reasonable request or from Research Data Deposit public platform(www.researchdata.org.cn, with approval RDD no. RDDA2019001061).

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Correspondence to Lin Zhang or Peidong Chi.

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To view digital features for this article go to: https://doi.org/10.6084/m9.figshare.12155853.

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Wang, X., Mao, M., Zhu, S. et al. A Novel Nomogram Integrated with Inflammation-Based Factors to Predict the Prognosis of Gastric Cancer Patients. Adv Ther 37, 2902–2915 (2020). https://doi.org/10.1007/s12325-020-01356-4

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  • DOI: https://doi.org/10.1007/s12325-020-01356-4

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