Nomograms of risk prediction and prognosis for the T1-T2 stage gastric cancer with lymph node metastasis: a population-based study.

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Frontiers in Medicine Pub Date : 2025-02-25 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1492041
Guo-Le Nie, Longlong Geng, Hao Zhang, Shicheng Chu, Hong Jiang
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Abstract

Background and aims: Lymph node metastasis plays a crucial role in determining the appropriate treatment approach for patients with gastric cancer (GC), particularly those in the T1-T2 stage. Currently available diagnostic strategies for GC with lymph nodes have limited accuracy. The present research aimed to create and validate diagnostic and prognostic nomograms specifically tailored for the T1-T2 stage GC patients with LNM.

Methods: We derived clinicopathological characteristics of patients diagnosed with GC from the Surveillance, Epidemiology, and End Results (SEER) database. We utilized univariate and multivariate logistic analyses to examine the risk factors linked with the occurrence of lymph node metastasis (LNM) in GC patients within the T1-T2 stage. Furthermore, the prognostic factors related to the T1-T2 stage GC patients with LNM were explored by univariate and multivariate cox analyses. Two nomograms were built by the risk factors screened above.

Results: Ultimately, our study included 5,350 patients with T1-T2 stage GC. After identifying age, T stage, tumor size, primary site, grade, and histological type as risk factors for the LNM occurrence, we successfully developed a diagnostic nomogram utilizing these variables. Age, T stage, M stage, tumor size, primary site, grade, radiation, surgery, and chemotherapy were all independent prognostic factors that related to the T1 - T2 GC patients with LNM. The results of the AUC, calibration curve and decision curve analysis (DCA) showed excellent calibration performance and clinical applicability of the two nomograms. The Kaplan-Meier (K-M) curves clearly demonstrated a notable distinction in overall survival between low-risk and high-risk groups, highlighting the prognostic significance of the nomogram.

Conclusion: The establishment and validation of the two nomograms for T1-T2 GC patients with LNM were successful, serving as valuable tools for clinical decision-making and the formulation of personalized treatment approaches.

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来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
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