Establishment and verification of a prognostic Nomogram for middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer
10.7619/jcmp.20242402
- VernacularTitle:中老年Ⅱ～Ⅲ期胃癌患者预后预测列线图模型的构建和验证
- Author:
Guoyu ZHU
1
;
Yang WU
;
Chen QIN
;
Xiaochun ZHANG
;
Wenji LI
Author Information
1. 扬州大学医学院,江苏扬州,225003
- Keywords:
prediction model;
gastric cancer;
middle-aged and elderly population;
overall survival;
real-world study
- From:
Journal of Clinical Medicine in Practice
2024;28(17):27-34,40
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct and validate a Nomogram prediction model for overall survival(OS)in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer.Methods The clinical,pathological,and follow-up data of middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer in the Affiliated Hospital of Yangzhou University,Northern Jiangsu People's Hospital,and Yangzhou City Hospital of Traditional Chinese Medicine from March 1,2012 to December 1,2022 were retro-spectively analyzed.Based on univariate and multivariate Cox regression analyses,the independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer were identi-fied,and a Nomogram prediction model was further constructed and validated.The diagnostic perform-ance of the model was evaluated by the receiver operating characteristic(ROC)curve and calibration curve,and the clinical effect of the model was assessed by decision curve analysis(DC A).Results A total of 382 patients were included.A total of 282 cases were as training sets and 100 cases were as validation sets.Univariate and multivariate Cox regression analyses indicated that family history of gas-tric cancer,vascular invasion,nerve invasion,T stage,and N stage were independent risk factors for OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer(P＜0.05).A prognostic Nomogram was constructed based on these variables,and the concordance index of the model in the training and validation sets was 0.667(95％CI,0.601 to 0.726)and 0.708(95％CI,0.622 to 0.766)respectively.The ROC curve indicated that the model had good predictive accuracy.The calibration curve showed that the predicted value of the model was in good agreement with the actual value.DC A demonstrated that the model had good clinical application and potential values.Con-clusion The Nomogram model for 1-,3-and 5-year OS in middle-aged and elderly patients with stage Ⅱ to Ⅲ gastric cancer constructed based on real-world big data in this study has an ideal pre-dictive effect,which can help clinicians effectively assess patients'prognosis.
