Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2023; 15(1): 49-59
Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.49
Development and validation of a novel nomogram for predicting overall survival in gastric cancer based on inflammatory markers
Pan-Quan Luo, En-Dong Song, Fei Liu, Abigail N Rankine, Li-Xiang Zhang, Zhi-Jian Wei, Wen-Xiu Han, A-Man Xu
Pan-Quan Luo, En-Dong Song, Li-Xiang Zhang, Zhi-Jian Wei, Wen-Xiu Han, A-Man Xu, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Fei Liu, Faculty of Medical Technology, Ophthalmology Laboratory, Anhui Medical College, Hefei 230601, Anhui Province, China
Abigail N Rankine, Department of Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China
Author contributions: Luo PQ collected the clinical information of patients, performed the statistical analysis, and completed the writing of the manuscript; Song ED and Liu F participated in collecting the clinical information of patients and revising the statistical methods of the investigation; Luo PQ, Song ED, and Liu F contributed equally to this work; Rankine AN helped perform the statistical analysis; Zhang LX, Wei ZJ, Han WX, and Xu AM designed the main study and critically revised the manuscript, and they contributed equally to this work; All authors read and approved the final manuscript.
Supported by Natural Science Foundation of Anhui Province, No. 2108085QH337.
Institutional review board statement: The First Affiliated Hospital of Anhui Medical University Institutional Review Board and Ethical Committee approved this study.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
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: A-Man Xu, Doctor, Professor, Surgeon, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China. 461961143@qq.com
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 5, 2022
Revised: October 18, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 27, 2023
Abstract
BACKGROUND

Nearly 66% of occurrences of gastric cancer (GC), which has the second-highest death rate of all cancers, arise in developing countries. In several cancers, the predictive significance of inflammatory markers has been established.

AIM

To identify clinical characteristics and develop a specific nomogram to determine overall survival for GC patients.

METHODS

Nine hundred and four GC patients treated at the First Affiliated Hospital of Anhui Medical University between January 2010 and January 2013 were recruited. Prognostic risk variables were screened for Cox analysis. The C index, receiver operator characteristic (ROC) curve, and decision curve analysis were used to evaluate the nomogram.

RESULTS

Tumor node metastasis stage, carcinoembryonic antigen, systemic immune-inflammation index, and age were identified as independent predictive variables by multivariate analysis. Systemic immune-inflammation index value was superior to that of other inflammatory indicators. The ROC indicated the nomogram had a higher area under the curve than other factors, and its C-index for assessing the validation and training groups of GC patients was extremely reliable.

CONCLUSION

We created a novel nomogram to forecast the prognosis of GC patients following curative gastrectomy based on blood markers and other characteristics. Both surgeons and patients can benefit significantly from this new scoring system.

Keywords: Gastric cancer, Nomogram, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Systemic immune-inflammation index

Core Tip: According to our study, the prognosis of patients with gastric cancer (GC) was significantly influenced by the systemic immune-inflammation index, carcinoembryonic antigen, tumor node metastasis stage, and age. We created a novel nomogram to predict the prognosis of GC patients following curative gastrectomy based on blood markers and other characteristics. Both surgeons and patients can benefit significantly from this new scoring system.