General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
J Investig Med. 2022 Aug;70(6):1373-1380. doi: 10.1136/jim-2021-002285. Epub 2022 Jul 5.
Currently, the postoperative prognosis of early stage gastric cancer (GC) is difficult to accurately predict. In particular, social factors are not frequently used in the prognostic assessment of early stage GC. Therefore, this study aimed to combine the clinical indicators and social factors to establish a predictive model for early stage GC based on a new scoring system. A total of 3647 patients with early stage GC from the Surveillance, Epidemiology, and End Results database were included in this study. A Kaplan-Meier survival analysis was used to compare differences in prognosis between different marital status, as an innovative prognostic indicator. Univariate and multivariate analyses were used to screen available prediction factors and then build a nomogram using the Cox proportional hazard regression model. The univariate analysis and multivariate analysis revealed that age at diagnosis, sex, histology, stage_T, surgery, tumor size, and marital status were independent prognostic factors of overall survival. Both the C-index and calibration curves confirmed that the nomogram had a great predictive effect on patient prognosis in training and testing sets. This nomogram based on clinical indicators and marital status can effectively help patients with early stage GC in the future.
目前,早期胃癌(GC)的术后预后难以准确预测。特别是,社会因素在早期 GC 的预后评估中并不常用。因此,本研究旨在结合临床指标和社会因素,建立一个基于新评分系统的早期 GC 预测模型。本研究共纳入了来自监测、流行病学和最终结果数据库的 3647 例早期 GC 患者。采用 Kaplan-Meier 生存分析比较不同婚姻状况之间预后的差异,将其作为一种创新的预后指标。采用单因素和多因素分析筛选可用的预测因素,然后使用 Cox 比例风险回归模型构建列线图。单因素和多因素分析表明,诊断时的年龄、性别、组织学、T 分期、手术、肿瘤大小和婚姻状况是总生存的独立预后因素。C 指数和校准曲线均证实,该列线图在训练集和测试集中对患者预后具有良好的预测效果。该基于临床指标和婚姻状况的列线图可有效帮助未来的早期 GC 患者。