Normalization weighted combination scores re-evaluate TNM staging of gastric cancer: a retrospective cohort study based on a multicenter database.
Journal
International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232
Informations de publication
Date de publication:
24 Nov 2023
24 Nov 2023
Historique:
received:
30
06
2023
accepted:
21
08
2023
medline:
24
11
2023
pubmed:
24
11
2023
entrez:
24
11
2023
Statut:
aheadofprint
Résumé
The pathological depth of tumor invasion (pT) and lymph node metastasis (pN) are critical independent prognostic factors for patients with gastric cancer, representing effective methods for evaluating prognosis. In this study, we employed a normalization weight combination score to calculate the weight ratio of the pT stage and pN stage. Subsequently, we established a novel wTN staging model based on these T and N weights, evaluating its prognostic capacity. This study utilized a training cohort from A Medical University Cancer Hospital and a validation cohort from the SEER database. LASSO and Cox regression were employed to screen clinical characteristics. Multivariate linear regression and cluster analysis calculated the weight ratio of T stage and N stage in the training and validation cohorts, respectively, followed by re-staging. Prognostic value was evaluated using C-index, likelihood ratio, Wald, and Score tests for wTN stage and TNM stage. A nomogram model was developed, and accuracy was assessed using ROC, DCA, and RCS analyses. LASSO was used for initial screening, selecting 8 potential features for Cox analysis. Age, tumor size, MLNs, and tumor location were confirmed as independent prognostic factors. wTN was calculated in the training and validation cohorts, and nomograms were established with the independent factors. N stage had a higher weight proportion than T stage in both cohorts (0.625/0.375 in training cohort, 0.556/0.444 in validation cohort). wTN outperformed the 8th TNM stage in C-index, likelihood ratio, Wald, and Score tests in the training cohort, with successful validation in the validation cohort. Stratified analysis of distinct pathological types further demonstrates that wTN staging exhibits superior prognostic performance. The wTN staging model based on T stage and N stage weights has a good prognostic value for gastric cancer patients. The same conclusion was obtained in different pathological stratification.
Sections du résumé
BACKGROUND
BACKGROUND
The pathological depth of tumor invasion (pT) and lymph node metastasis (pN) are critical independent prognostic factors for patients with gastric cancer, representing effective methods for evaluating prognosis. In this study, we employed a normalization weight combination score to calculate the weight ratio of the pT stage and pN stage. Subsequently, we established a novel wTN staging model based on these T and N weights, evaluating its prognostic capacity.
METHODS
METHODS
This study utilized a training cohort from A Medical University Cancer Hospital and a validation cohort from the SEER database. LASSO and Cox regression were employed to screen clinical characteristics. Multivariate linear regression and cluster analysis calculated the weight ratio of T stage and N stage in the training and validation cohorts, respectively, followed by re-staging. Prognostic value was evaluated using C-index, likelihood ratio, Wald, and Score tests for wTN stage and TNM stage. A nomogram model was developed, and accuracy was assessed using ROC, DCA, and RCS analyses.
RESULTS
RESULTS
LASSO was used for initial screening, selecting 8 potential features for Cox analysis. Age, tumor size, MLNs, and tumor location were confirmed as independent prognostic factors. wTN was calculated in the training and validation cohorts, and nomograms were established with the independent factors. N stage had a higher weight proportion than T stage in both cohorts (0.625/0.375 in training cohort, 0.556/0.444 in validation cohort). wTN outperformed the 8th TNM stage in C-index, likelihood ratio, Wald, and Score tests in the training cohort, with successful validation in the validation cohort. Stratified analysis of distinct pathological types further demonstrates that wTN staging exhibits superior prognostic performance.
CONCLUSION
CONCLUSIONS
The wTN staging model based on T stage and N stage weights has a good prognostic value for gastric cancer patients. The same conclusion was obtained in different pathological stratification.
Identifiants
pubmed: 38000074
doi: 10.1097/JS9.0000000000000726
pii: 01279778-990000000-00813
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.