Analysis of prognostic factors in patients with resectable gastric cancer with vascular cancer thrombus
10.3969/j.issn.1672-2159.2024.02.007
- VernacularTitle:可切除胃癌伴脉管癌栓患者预后影响因素分析
- Author:
Ze-Feng YANG
1
;
Xiang-Yu CHENG
;
Hong-Mei YU
;
Yu-Sheng WANG
Author Information
1. 030001 山西医科大学公共卫生学院卫生统计学教研室
- Keywords:
Gastric cancer;
Vascular cancer thrombus;
Clinical pathological features;
Column chart;
Prognostic model
- From:
Modern Interventional Diagnosis and Treatment in Gastroenterology
2024;29(2):151-157
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors influencing the prognosis of patients with Resectable gastric adenocarcinoma with vascular cancer thrombus(RGAVCT)and to develop a relevant columnar graphic prognostic model.Methods Clinicopathologic data of 530 patients with gastric adenocarcinoma combined with vascular cancer embolization who underwent radical gastrectomy for gastric cancer at the Affiliated Cancer Hospital of Shanxi Medical University were retrospectively collected from January 2017 to January 2022,and were randomly assigned to the training cohort and the validation cohort in a 7∶3 ratio.Kaplan-Meier curves and Log-rank test and multifactorial Cox regression were used to analyze the risk factors for death in the training cohort patients,and to construct Nomogram Model for the probability of survival at 1,2,and 4 years in RGAVCT patients.ROC curves were used to analyze the efficacy of the Nomogram model in the training cohort and validation cohort patients.Results Age,postoperative chemotherapy,tumor size,Ki67 expression status,T-stage,N-stage,and clinical stage of patients in the training cohort were the influencing factors on survival(OS)of patients with RGAVCT(P<0.05);postoperative chemotherapy(P<0.001,HR=0.302,95%CI:0.219-0.418),T-stage[T3(P=0.015,HR=11.782,95%CI:1.628-85.283),T4a+4b(P=0.005,HR=17.219,95%CI:2.343-126.559)],N staging[N2(P=0.309,HR=1.310,95%CI:0.779-2.201)N3a(P=0.001,HR=2.268,95%CI:1.407-3.657),N3b(P<0.001,HR=2.836,95%CI:1.708-4.709)]were independent influences on OS in patients with RGAVCT.Cox regression results were used to develop nomogram models for predicting the probability of patients'survival at 1,2,and 4 years after surgery.The AUROC area and C index were>0.7 for the training cohort and>0.67 for the validation cohort.Conclusion In this study,we developed a nomogram model of 1-,2-,and 4-year postoperative survival probabilities of RGAVCT patients,which can better predict the postoperative survival of RGAVCT patients.