Wang Chen, Chen Meng-Yan, Wang Yu-Gang, Shi Min
Department of Gastroenterology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.
World J Clin Oncol. 2025 Aug 24;16(8):109934. doi: 10.5306/wjco.v16.i8.109934.
This letter is a commentary on the findings of Huang , who emphasize the prognostic value of tumor location in gastric cancer. Analyzing data from 3287 patients using Kaplan-Meier and multivariate Cox models, the authors found that the tumor location correlated with patient prognosis following surgery. Patients with tumors situated nearer to the stomach's proximal end were associated with shorter survival periods and poorer outcomes. Notably, gender-based differences in tumor markers, particularly carbohydrate antigen 72-4, further highlight the need for sex-specific influence on the tumor location. Despite increasing recognition of tumor location as a prognostic factor, its role remains unclear in clinical prediction models for various cancers. This letter highlights the potential of incorporating tumor location into artificial intelligence -based prognostic tools to enhance prognostic models. It also outlines a stepwise framework for developing these models, from retrospective training to prospective multicenter validation and clinical implementation. In addition, it addresses the technical, ethical, and interoperability challenges critical to successful real-world prognosis.
这封信是对黄等人研究结果的评论，他们强调了肿瘤位置在胃癌中的预后价值。作者使用Kaplan-Meier和多变量Cox模型分析了3287例患者的数据，发现肿瘤位置与手术后患者的预后相关。肿瘤位置更靠近胃近端的患者生存期较短，预后较差。值得注意的是，肿瘤标志物尤其是糖类抗原72-4存在基于性别的差异，这进一步凸显了性别特异性对肿瘤位置影响的必要性。尽管越来越认识到肿瘤位置是一个预后因素，但其在各种癌症的临床预测模型中的作用仍不明确。这封信强调了将肿瘤位置纳入基于人工智能的预后工具以增强预后模型的潜力。它还概述了开发这些模型的逐步框架，从回顾性训练到前瞻性多中心验证及临床应用。此外，它还探讨了对成功进行现实世界预后至关重要的技术、伦理和互操作性挑战。
