Abstract
Background The lung is one of the most common sites of metastasis in gastric cancer. Our study developed two nomograms to achieve individualized prediction of overall survival (OS) and cancer-specific survival (CSS) in patients with gastric cancer and lung metastasis (GCLM) to better guide follow-up and planning of subsequent treatment. Methods We reviewed data of patients diagnosed with GCLM in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. The endpoints of the study were the OS and CSS. We used the “caret” package to randomly divide patients into training and validation cohorts in a 7 : 3 ratio. Multivariate Cox regression analysis was performed using univariate Cox regression analysis to confirm the independent prognostic factors. Afterward, we built the OS and CSS nomograms with the “rms” package. Subsequently, we evaluated the two nomograms through calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Finally, two web-based nomograms were built on the basis of effective nomograms. Results The OS analysis included 640 patients, and the results of the multivariate Cox regression analysis showed that grade, chemotherapy, and liver metastasis were independent prognostic factors for patients with GCLM. The CSS analysis included 524 patients, and the results of the multivariate Cox regression analysis showed that the independent prognostic factors for patients with GCLM were chemotherapy, liver metastasis, marital status, and tumor site. The ROC curves, calibration curves, and DCA revealed favorable predictive power in the OS and CSS nomograms. We created web-based nomograms for OS (https://zhenghh.shinyapps.io/aclmos/) and CSS (https://zhenghh.shinyapps.io/aslmcss/). Conclusions We created two web-based nomograms to predict OS and CSS in patients with GCLM. Both web-based nomograms had satisfactory accuracy and clinical usefulness and may help clinicians make individualized treatment decisions for patients.
Highlights
Gastric cancer (GC) is one of the most common malignant tumors of the gastrointestinal tract, accounting for the third and fifth causes of cancer deaths in men and women worldwide, respectively [1]
Radical surgery is currently effective in treating localized GC, recurrence or metastasis still occurs in 25% to 40% of patients after surgery [2,3,4]
There is a lack of mature therapy standards for gastric cancer and lung metastasis (GCLM), and the 5year survival rate of patients with GCLM is
Summary
Gastric cancer (GC) is one of the most common malignant tumors of the gastrointestinal tract, accounting for the third and fifth causes of cancer deaths in men and women worldwide, respectively [1]. The lung is a frequent metastatic organ in patients with GC [5], and the incidence of lung metastasis (LM) after GC surgery ranges from 1.3% to 3.8% [6,7,8,9,10]. There is a lack of mature therapy standards for gastric cancer and lung metastasis (GCLM), and the 5year survival rate of patients with GCLM is
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