Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2023; 15(3): 533-545
Published online Mar 15, 2023. doi: 10.4251/wjgo.v15.i3.533
Nomogram model predicting the overall survival for patients with primary gastric mucosa-associated lymphoid tissue lymphoma
Dan Wang, Xin-Lin Shi, Wei Xu, Rui-Hua Shi
Dan Wang, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
Dan Wang, Wei Xu, Rui-Hua Shi, Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, Nanjing 210009, Jiangsu Province, China
Dan Wang, Wei Xu, Rui-Hua Shi, Laboratory of Gastroenterology, Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China
Xin-Lin Shi, Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Author contributions: Shi RH contributed to conceptualization and supervision; Wang D contributed to conceptualization, data curation, formal analysis, and writing-original draft preparation; Shi XL contributed to data curation and formal analysis; Xu W contributed to supervision and editing; all authors approved the manuscript.
Institutional review board statement: The study was reviewed and approved by the Zhongda Hospital, Affiliated Hospital of Southeast University, all our data comes from public database (SEER database) and need no ethical approval.
Informed consent statement: The informed consent was waived because all of data were downloaded from open database “SEER Database”.
Conflict-of-interest statement: All authors of this paper have no conflict of interests to disclose.
Data sharing statement: No additional data are available.
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: Rui-Hua Shi, PhD, Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, No. 87 Hunan Road, Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. ruihuashi@126.com
Received: November 13, 2022
Peer-review started: November 13, 2022
First decision: January 11, 2023
Revised: February 9, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 15, 2023
Processing time: 121 Days and 13.6 Hours
ARTICLE HIGHLIGHTS
Research background

Extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue, known as MALT lymphoma, is a type of non-Hodgkin’s lymphoma. The prognosis of primary gastric MALT (GML) patients can be affected by many factors. Few studies have investigated the prognostic variables for overall survival (OS) in patients with primary GML. We searched a large amount of data on patients diagnosed with primary GML in the Surveillance, Epidemiology and End Results (SEER) database.

Research motivation

In this study, we investigated the significant risk factors of primary GML and build an effective survival nomogram model for primary GML patients.

Research objectives

To develop and verify a survival nomogram model that can predict the OS prognosis of primary GML by combining prognostic and determinant variables.

Research methods

All data of patients with primary GML were collected from the SEER database. Based on the LASSO and COX regression, we created and further verified the accuracy and effectiveness of the survival nomogram model by the concordance index (C-index), calibration curve and time-dependent receiver operating characteristic (td-ROC) curves.

Research results

A total of 2604 patients diagnosed with primary GML were selected for this study. A total of 1823 and 781 people were randomly distributed into the training and testing sets at a ratio of 7:3. The median follow-up of all patients was 71 mo, and the 3- and 5-year OS rates were 87.2% and 79.8%, respectively. Age, sex, race, Ann Arbor stage and radiation were independent risk factors for OS of primary GML (all P < 0.05). The C-index values of the nomogram were 0.751 (95%CI: 0.729-0.773) and 0.718 (95%CI: 0.680-0.757) in the training and testing cohorts, respectively, showing the good discrimination ability of the nomogram model. Td-ROC curves and calibration plots also indicated satisfactory predictive power and good agreement of the model. Overall, the nomogram shows favorable performance in discriminating and predicting the OS of patients with primary GML.

Research conclusions

A nomogram was developed and validated to have good survival predictive performance based on five clinical independent risk factors for OS for primary GML patients.

Research perspectives

Nomograms are a low-cost and convenient clinical tool in assessing individualized prognosis and treatment for patients with primary GML.