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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2023; 15(4): 665-676
Published online Apr 15, 2023. doi: 10.4251/wjgo.v15.i4.665
Nomogram established using risk factors of early gastric cancer for predicting the lymph node metastasis
Xiao-Cong Jiang, Xiao-Bing Yao, Heng-Bo Xia, Ye-Zhou Su, Pan-Quan Luo, Jian-Ran Sun, En-Dong Song, Zhi-Jian Wei, A-Man Xu, Li-Xiang Zhang, Yu-Hong Lan
Xiao-Cong Jiang, Yu-Hong Lan, Department of Radiotherapy Oncology, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong Province, China
Xiao-Bing Yao, Emergency Surgery, Shanghai Seventh People’s Hospital, Shanghai 200137, China
Heng-Bo Xia, Pan-Quan Luo, En-Dong Song, Zhi-Jian Wei, A-Man Xu, Li-Xiang Zhang, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
Ye-Zhou Su, Department of Obstetrics and Gynecology, First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
Jian-Ran Sun, Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, Hefei 230031, Anhui Province, China
Li-Xiang Zhang, Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
Author contributions: Jiang XC, Yao XB, Xia HB, and Su YZ provided the databases, conducted the statistical analysis, and drafted the manuscript; Jiang XC, Yao XB, Xia HB, and Su YZ made the contribution to the main work equally and share the first authorship; Luo PQ, Sun JR analyzed the data and revised the manuscript; Song ED helped them; Xu AM, Wei ZJ, Zhang LX, and Lan YH designed the main study and critically revised the manuscript; Xu AM, Wei ZJ, Zhang LX, and Lan YH are all the correspondence author; all authors read and approved the final manuscript.
Institutional review board statement: Institutional review board statement was not acquired since data were obtained from the SEER database that covering approximately 28% of the cases in the United States.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data can be obtained from the correspondence. The collection of patient information did not require informed consent nor institutional review because such information was publicly available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yu-Hong Lan, MD, Doctor, Department of Radiotherapy Oncology, Huizhou Municipal Central Hospital, No. 41 Eling North Road, Huizhou 516001, Guangdong Province, China.
lll931682207@qq.com
Received: November 12, 2022
Peer-review started: November 12, 2022
First decision: January 3, 2023
Revised: January 12, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: April 15, 2023
Processing time: 150 Days and 17.4 Hours
BACKGROUND
For the prognosis of patients with early gastric cancer (EGC), lymph node metastasis (LNM) plays a crucial role. A thorough and precise evaluation of the patient for LNM is now required.
AIM
To determine the factors influencing LNM and to construct a prediction model of LNM for EGC patients.
METHODS
Clinical information and pathology data of 2217 EGC patients downloaded from the Surveillance, Epidemiology, and End Results database were collected and analyzed. Based on a 7:3 ratio, 1550 people were categorized into training sets and 667 people were assigned to testing sets, randomly. Based on the factors influencing LNM determined by the training sets, the nomogram was drawn and verified.
RESULTS
Based on multivariate analysis, age at diagnosis, histology type, grade, T-stage, and size were risk factors of LNM for EGC. Besides, nomogram was drawn to predict the risk of LNM for EGC patients. Among the categorical variables, the effect of grade (well, moderate, and poor) was the most significant prognosis factor. For training sets and testing sets, respectively, area under the receiver-operating characteristic curve of nomograms were 0.751 [95% confidence interval (CI): 0.721-0.782] and 0.786 (95%CI: 0.742-0.830). In addition, the calibration curves showed that the prediction model of LNM had good consistency.
CONCLUSION
Age at diagnosis, histology type, grade, T-stage, and tumor size were independent variables for LNM in EGC. Based on the above risk factors, prediction model may offer some guiding implications for the choice of subsequent therapeutic approaches for EGC.
Core Tip: A model was constructed to evaluate the impact of various indicators in an integrated manner to serve as a base for predicting lymph node metastasis (LNM) in early gastric cancer (EGC) patients. Age at diagnosis, histology type, grade, T-stage, and tumor size were independent hazard elements for LNM in EGC.
