Abstract
Objective The study was to develop and externally validate a prognostic nomogram to effectively predict the overall survival of patients with stomach cancer. Methods Demographic and clinical variables of patients with stomach cancer in the Surveillance, Epidemiology, and End Results (SEER) database from 2007–2016 were retrospectively collected. Patients were then divided into the Training Group (n = 4,456) for model development and the Testing Group (n = 4,541) for external validation. Univariate and multivariate Cox regressions were used to explore prognostic factors. The concordance index (C-index) and the Kolmogorov–Smirnov (KS) value were used to measure the discrimination, and the calibration curve was used to assess the calibration of the nomogram. Results Prognostic factors including age, race, marital status, TNM stage, surgery, chemotherapy, grade, and the number of regional nodes positive were used to construct a nomogram. The C-index was 0.790 and the KS value was 0.45 for the Training Group, and the C-index was 0.789 for the Testing Group, all suggesting the good performance of the nomogram. Conclusion We have developed an effective nomogram with ten easily acquired prognostic factors. The nomogram could accurately predict the overall survival of patients with stomach cancer and performed well on external validation, which would help improve the individualized survival prediction and decision-making, thereby improving the outcome and survival of stomach cancer.
Highlights
Stomach cancer is a kind of malignant tumor with high invasiveness and heterogeneity, which is a global health problem [1]
It is estimated that about 783,000 people died of stomach cancer in 2018, and 769,000 died in 2020 globally [2, 4]. ere will be approximately 26,560 new cases of stomach cancer and 11,180 deaths in the United States in according to the American Cancer Society. e prognosis of early stomach cancer is relatively good, and the 5-year survival rate is about 69–82% [5]
We aimed to develop a prognostic nomogram, which included patients with or without surgery and other treatments, using easy-to-collect demographic and clinicopathological variables (TNM stage, surgery, chemotherapy, grade, and the number of regional nodes positive). e prognostic nomogram may help clinicians more accurately predict the overall survival of patients with stomach cancer, thereby optimizing the treatment selection and improving the prognosis of cancer
Summary
Stomach cancer is a kind of malignant tumor with high invasiveness and heterogeneity, which is a global health problem [1]. It remains the fifth most common cancer and the third leading killer of cancer-related deaths worldwide despite the decreasing trend of new morbidity and mortality [2, 3]. E prognosis of early stomach cancer is relatively good, and the 5-year survival rate is about 69–82% [5]. Despite advances in radical surgical techniques and perioperative chemotherapy, the survival rate of patients with advanced stomach cancer remains poor. It is of great significance to identify independent prognostic factors of stomach cancer for the better treatment and prognosis of cancer
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