Screening high-risk individuals for primary gastric carcinoma: evaluating overall survival probability score in the presence and absence of lymphatic metastasis post-gastrectomy.
Gastric cancer
Lymphatic metastasis
Nomogram
Overall survival
Risk stratification
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
25 Jul 2024
25 Jul 2024
Historique:
received:
26
03
2024
accepted:
17
07
2024
medline:
26
7
2024
pubmed:
26
7
2024
entrez:
25
7
2024
Statut:
epublish
Résumé
The aim of this study was to develop and validate prognostic models for predicting overall survival in individuals with gastric carcinoma, specifically focusing on both negative and positive lymphatic metastasis. A total of 1650 patients who underwent radical gastric surgery at Shanxi Cancer Hospital between May 2002 and December 2020 were included in the analysis. Multiple Cox Proportional Hazards analysis was performed to identify key variables associated with overall survival in both negative and positive lymphatic metastasis cases. Internal validation was conducted using bootstrapping to assess the prediction accuracy of the models. Calibration curves were used to demonstrate the accuracy and consistency of the predictions. The discriminative abilities of the prognostic models were evaluated and compared with the 8th edition of AJCC-TNM staging using Harrell's Concordance index, decision curve analysis, and time-dependent receiver operating characteristic curves. The nomogram for node-negative lymphatic metastasis included variables such as age, pT stage, and maximum tumor diameter. The C-index for this model in internal validation was 0.719, indicating better performance compared to the AJCC 8th edition TNM staging. The nomogram for node-positive lymphatic metastasis included variables such as gender, age, maximum tumor diameter, neural invasion, Lauren classification, and expression of Her-2, CK7, and CD56. The C-index for this model was 0.674, also outperforming the AJCC 8th edition TNM staging. Calibration curves, time-dependent receiver operating characteristic curves, and decision curve analysis for both nomograms demonstrated excellent prediction ability. Furthermore, significant differences in prognosis between low- and high-risk groups supported the models' strong risk stratification performance. This study provides valuable risk stratification models for lymphatic metastasis in gastric carcinoma, encompassing both node-positive and negative cases. These models can help identify low-risk individuals who may not require further intervention, while high-risk individuals can benefit from targeted therapies aimed at addressing lymphatic metastasis.
Identifiants
pubmed: 39054533
doi: 10.1186/s12957-024-03481-8
pii: 10.1186/s12957-024-03481-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
196Subventions
Organisme : the Science and Education Cultivation Fund of the National Cancer and Regional Medical center of Shanxi Provincial Cancer hospital
ID : SD2023005
Organisme : the Science and Education Cultivation Fund of the National Cancer and Regional Medical center of Shanxi Provincial Cancer hospital
ID : SD2023005
Informations de copyright
© 2024. The Author(s).
Références
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
doi: 10.3322/caac.21660
pubmed: 33538338
Ajani JA, Lee J, Sano T, Janjigian YY, Fan D, Song S. Gastric adenocarcinoma. Nat Rev Dis Primers. 2017;3:17036.
doi: 10.1038/nrdp.2017.36
pubmed: 28569272
Bourke MJ, Neuhaus H, Bergman JJ. Endoscopic submucosal dissection: indications and application in western endoscopy practice. Gastroenterology. 2018;154(7):1887–e19005.
doi: 10.1053/j.gastro.2018.01.068
pubmed: 29486200
Salati M, Orsi G, Smyth E, Aprile G, Beretta G, De Vita F, Di Bartolomeo M, Fanotto V, Lonardi S, Morano F, Pietrantonio F, Pinto C, Rimassa L, Vasile E, Vivaldi C, Zaniboni A, Ziranu P, Cascinu S. Gastric cancer: translating novels concepts into clinical practice. Cancer Treat Rev. 2019;79:101889.
doi: 10.1016/j.ctrv.2019.101889
pubmed: 31445415
Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F. Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev. 2014;23(5):700–13.
doi: 10.1158/1055-9965.EPI-13-1057
pubmed: 24618998
pmcid: 4019373
Biagioni A, Skalamera I, Peri S, Schiavone N, Cianchi F, Giommoni E, Magnelli L, Papucci L. Update on gastric cancer treatments and gene therapies. Cancer Metastasis Rev. 2019;38(3):537–48.
doi: 10.1007/s10555-019-09803-7
pubmed: 31486976
In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T. Validation of the 8th edition of the AJCC TNM staging system for gastric cancer using the national cancer database. Ann Surg Oncol. 2017;24(12):3683–91.
doi: 10.1245/s10434-017-6078-x
pubmed: 28895113
Katai H, Ishikawa T, Akazawa K, Isobe Y, Miyashiro I, Oda I, Tsujitani S, Ono H, Tanabe S, Fukagawa T, Nunobe S, Kakeji Y, Nashimoto A, Registration Committee of the Japanese Gastric Cancer Association. Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001–2007). Gastric Cancer. 2018;21(1):144–54.
doi: 10.1007/s10120-017-0716-7
pubmed: 28417260
Kattan MW, Karpeh MS, Mazumdar M, Brennan MF. Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma. J Clin Oncol. 2003;21(19):3647–50.
doi: 10.1200/JCO.2003.01.240
pubmed: 14512396
Li Z, Wu X, Gao X, Shan F, Ying X, Zhang Y, Ji J. Development and validation of an artificial neural network prognostic model after gastrectomy for gastric carcinoma: an international multicenter cohort study. Cancer Med. 2020;9(17):6205–15.
doi: 10.1002/cam4.3245
pubmed: 32666682
pmcid: 7476835
Han DS, Suh YS, Kong SH, Lee HJ, Choi Y, Aikou S, Sano T, Park BJ, Kim WH, Yang HK. Nomogram predicting long-term survival after d2 gastrectomy for gastric cancer. J Clin Oncol. 2012;30(31):3834–40.
doi: 10.1200/JCO.2012.41.8343
pubmed: 23008291
Li Y, Zhang X. Prognostic nomograms for gastric carcinoma after surgery to assist decision-making for postoperative treatment with chemotherapy cycles < 9 or chemotherapy cycles ≥ 9. Front Surg. 2022;9:916483.
doi: 10.3389/fsurg.2022.916483
pubmed: 36090344
pmcid: 9458925
Li Y, Bai M, Gao Y. Prognostic nomograms for gastric carcinoma after D2 + total gastrectomy to assist decision-making for postoperative treatment: based on Lasso regression. World J Surg Oncol. 2023;21(1):207.
doi: 10.1186/s12957-023-03097-4
pubmed: 37475024
pmcid: 10357773
Spolverato G, Ejaz A, Kim Y, Squires MH, Poultsides G, Fields RC, Bloomston M, Weber SM, Votanopoulos K, Acher AW, Jin LX, Hawkins WG, Schmidt C, Kooby DA, Worhunsky D, Saunders N, Cho CS, Levine EA, Maithel SK, Pawlik TM. Prognostic performance of different lymph node staging systems after curative intent resection for gastric adenocarcinoma. Ann Surg. 2015;262(6):991–8.
doi: 10.1097/SLA.0000000000001040
pubmed: 25563867
Wang W, Xu DZ, Li YF, Guan YX, Sun XW, Chen YB, Kesari R, Huang CY, Li W, Zhan YQ, Zhou ZW. Tumor-ratio-metastasis staging system as an alternative to the 7th edition UICC TNM system in gastric cancer after D2 resection–results of a single-institution study of 1343 Chinese patients. Ann Oncol. 2011;22(9):2049–56.
doi: 10.1093/annonc/mdq716
pubmed: 21310759
Rawicz-Pruszyński K, Ciseł B, Mlak R, Mielko J, Skórzewska M, Kwietniewska M, Pikuła A, Gęca K, Sędłak K, Kurylcio A, Polkowski WP. The role of the lymph node ratio in advanced gastric cancer after neoadjuvant chemotherapy. Cancers (Basel). 2019;11(12):1914.
doi: 10.3390/cancers11121914
pubmed: 31805755
Dong D, Fang MJ, Tang L, Shan XH, Gao JB, Giganti F, Wang RP, Chen X, Wang XX, Palumbo D, Fu J, Li WC, Li J, Zhong LZ, De Cobelli F, Ji JF, Liu ZY, Tian J. Deep learning radiomic nomogram can predict the number of lymph node metastasis in locally advanced gastric cancer: an international multicenter study. Ann Oncol. 2020;31(7):912–20.
doi: 10.1016/j.annonc.2020.04.003
pubmed: 32304748
Gong Y, Pan S, Wang X, Zhu G, Xu H, Zhu Z. A novel lymph node staging system for gastric cancer including modified union for cancer Control/American Joint Committee on cancer and Japanese Gastric Cancer Association criteria. Eur J Surg Oncol. 2020;46(10 Pt B):e27–32.
doi: 10.1016/j.ejso.2020.06.005
pubmed: 32631708
Gu P, Deng J, Wang W, Wang Z, Zhou Z, Xu H, Liang H. Impact of the number of examined lymph nodes on stage migration in node-negative gastric cancer patients: a Chinese multi-institutional analysis with propensity score matching. Ann Transl Med. 2020;8(15):938.
doi: 10.21037/atm-19-4727
pubmed: 32953738
pmcid: 7475395
Kim YI. Does the retrieval of at least 15 lymph nodes confer an improved survival in patients with advanced gastric cancer? J Gastric Cancer. 2014;14:111–6.
doi: 10.5230/jgc.2014.14.2.111
pubmed: 25061538
pmcid: 4105375
Volpe CM, Driscoll DL, Douglass HO Jr. Outcome of patients with proximal gastric cancer depends on the extent of resection and number of resected lymph nodes. Ann Surg Oncol. 2000;7:139–44.
doi: 10.1007/s10434-000-0139-1
pubmed: 10761793
Marchet A, Mocellin S, Ambrosi A, de Manzoni G, Di Leo A, Marrelli D, Roviello F, Morgagni P, Saragoni L, Natalini G, De Santis F, Baiocchi L, Coniglio A, Nitti D, Italian Research Group for Gastric Cancer Study (GIRCG). The prognostic value of N-ratio in patients with gastric cancer: validation in a large, multicenter series. Eur J Surg Oncol. 2008;34(2):159–65.
doi: 10.1016/j.ejso.2007.04.018
pubmed: 17566691
Kong SH, Lee HJ, Ahn HS, Kim JW, Kim WH, Lee KU, Yang HK. Stage migration effect on survival in gastric cancer surgery with extended lymphadenectomy: the reappraisal of positive lymph node ratio as a proper N-staging. Ann Surg. 2012;255(1):50–8.
doi: 10.1097/SLA.0b013e31821d4d75
pubmed: 21577089
Wang F, Sun GP, Zou YF, Zhong F, Ma T, Li XQ, Wu D. Helicobacter pylori infection predicts favorable outcome in patients with gastric cancer. Curr Oncol. 2013;20(5):e388–95.
doi: 10.3747/co.20.1417
pubmed: 24155636
pmcid: 3805408
Lu J, Zheng ZF, Wang W, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M, Tu RH, Zhou ZW, Huang CM, Zheng CH, Li P. A novel TNM staging system for gastric cancer based on the metro-ticket paradigm: a comparative study with the AJCC-TNM staging system. Gastric Cancer. 2019;22(4):759–68.
doi: 10.1007/s10120-018-00904-w
pubmed: 30612230
Zhou YY, Kang YT, Chen C, Xu FF, Wang HN, Jin R. Combination of TNM staging and pathway based risk score models in patients with gastric cancer. J Cell Biochem. 2018;119(4):3608–17.
doi: 10.1002/jcb.26563
pubmed: 29231991
Lu J, Zheng ZF, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M, Tu RH, Huang CM, Zheng CH, Li P. Is the 8th edition of the AJCC TNM staging system sufficiently reasonable for all patients with noncardia gastric cancer? A 12,549-patient international database study. Ann Surg Oncol. 2018;25(7):2002–11.
doi: 10.1245/s10434-018-6447-0
pubmed: 29725896
Iasonos A, Schrag D, Raj GV, Panageas KS. How to build and interpret a nomogram for cancer prognosis. J Clin Oncol. 2008;26(8):1364–70.
doi: 10.1200/JCO.2007.12.9791
pubmed: 18323559
Necchi A, Sonpavde G, Lo Vullo S, Giardiello D, Bamias A, Crabb SJ, Harshman LC, Bellmunt J, De Giorgi U, Sternberg CN, Cerbone L, Ladoire S, Wong YN, Yu EY, Chowdhury S, Niegisch G, Srinivas S, Vaishampayan UN, Pal SK, Agarwal N, Alva A, Baniel J, Golshayan AR, Morales-Barrera R, Bowles DW, Milowsky MI, Theodore C, Berthold DR, Daugaard G, Sridhar SS, Powles T, Rosenberg JE, Galsky MD, Mariani L. RISC investigators. Nomogram-based prediction of overall survival in patients with metastatic urothelial carcinoma receiving first-line platinum-based chemotherapy: retrospective international study of invasive/advanced cancer of the urothelium (RISC). Eur Urol. 2017;71(2):281–9.
doi: 10.1016/j.eururo.2016.09.042
pubmed: 27726966
Yip PL, Lee SF, Choi CH, Chan PS, Cheung KA, Chow CJ, Cheung KM, Lai WJ, Lee HV, Lam KO, Chiang CL, Wong CE, Poon MD, Tong M, Au KH, Ng WT, Ngan KR, Lee WA, Tung YS. External validation of a nomogram to predict survival and benefit of concurrent chemoradiation for stage II nasopharyngeal carcinoma. Cancers (Basel). 2021;13(17):4286.
doi: 10.3390/cancers13174286
pubmed: 34503096
Raghav K, Hwang H, Jácome AA, Bhang E, Willett A, Huey RW, Dhillon NP, Modha J, Smaglo B, Matamoros A Jr, Estrella JS, Jao J, Overman MJ, Wang X, Greco FA, Loree JM, Varadhachary GR. Development and validation of a novel nomogram for individualized prediction of survival in cancer of unknown primary. Clin Cancer Res. 2021;27(12):3414–21.
doi: 10.1158/1078-0432.CCR-20-4117
pubmed: 33858857
pmcid: 8197749
Chang YR, Huang WK, Wang SY, Wu CE, Chen JS, Yeh CN. A nomogram predicting progression free survival in patients with gastrointestinal stromal tumor receiving sunitinib: incorporating pre-treatment and post-treatment parameters. Cancers (Basel). 2021;13(11):2587.
doi: 10.3390/cancers13112587
pubmed: 34070456
Liu H, Li Z, Zhang Q, Li Q, Zhong H, Wang Y, Yang H, Li H, Wang X, Li K, Wang D, Kong X, He Z, Wang W, Wang L, Zhang D, Xu H, Yang L, Chen Y, Zhou Y, Xu Z. Multi–institutional development and validation of a nomogram to predict prognosis of early-onset gastric cancer patients. Front Immunol. 2022;13:1007176.
doi: 10.3389/fimmu.2022.1007176
pubmed: 36148218
pmcid: 9488636
Li H, Lin D, Yu Z, Li H, Zhao S, Hainisayimu T, Liu L, Wang K. A nomogram model based on the number of examined lymph nodes-related signature to predict prognosis and guide clinical therapy in gastric cancer. Front Immunol. 2022;13:947802.
doi: 10.3389/fimmu.2022.947802
pubmed: 36405735
pmcid: 9667298