Our goal was to develop a prognostic nomogram to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric cardia cancer (GCC). Patients diagnosed with GCC from 2004 to 2015 were screened from the surveillance, epidemiology, and end results (SEER) database. A nomogram was developed based on the variables associated with oS and cSS using multivariate cox analysis regression models, which predicted 3-and 5-year OS and CSS. The predictive performance of the nomogram was evaluated using the consistency index (C-index), calibration curve and decision curve analysis (DCA), and the nomogram was calibrated for 3-and 5-year OS and CSS. A total of 7,332 GCC patients were identified and randomized into a training cohort (5,231, 70%) and a validation cohort (2,200, 30%). Multivariate Cox regression analysis showed that marital status, race, SEER stage, grade, T stage, N stage, M stage, tumor size, and surgery were independent risk factors for OS and CSS in GCC patients. Based on the multivariate Cox regression results, we constructed prognostic nomograms of OS and CSS. In the training cohort, the C-index for the OS nomogram was 0.714 (95% CI = 0.705-0.723), and the C-index for the CSS nomogram was 0.759 (95% CI = 0.746-0.772). In the validation cohort, the C-index for the OS nomogram was 0.734 (95% CI = 0.721-0.747), while the C-index for the CSS nomogram was 0.780 (95% CI = 0.759-0.801). Our nomogram has better prediction than the nomogram based on TNM stage. In addition, in the training and external validation cohorts, the calibration curves of the nomogram showed good consistency between the predicted and actual 3and 5-year OS and CSS rates. The nomogram can effectively predict OS and CSS in GCC patients, which may help clinicians personalize prognostic assessments and clinical decisions. Gastric cancer is the 6th most common cancer and the 3rd leading cause of tumor-related death worldwide 1. It was reported that there were approximately 27,510 new cases of gastric cancer resulting in 11,140 deaths in the United States in 2019 1. Anatomically, gastric cancer can be divided into gastric cardiac carcinoma (GCC) and non-cardia gastric cancer (NGCC). In recent decades, although the overall incidence of gastric cancer has declined worldwide 2 , the incidence of GCC has increased 3. This may be due to the increased incidence of gastroesophageal reflux disease and obesity 4. According to previous reports, there are significant differences in incidence and prognostic specificity between GCC and NGCC, indicating that they are different tumor entities 5-7. GCC has a poor prognosis and is a serious threat to human health 8. At present, the prognosis of GCC is mainly predicted by the TNM staging system 9. The TNM classification proposed by the American Joint Commission on Cancer (AJCC) is the most widely used staging system, and it is mainly based on tumor invasion (T), regional lymph node (N) and distant metastasis (M) to predict the survival
Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.
Introduction: Our aim was to determine the relationship between surgical compliance and survival outcomes in patients with stage T1-2 non-small-cell lung cancer (NSCLC). Methods: Patients with T1-2 NSCLC who were diagnosed between 2004 and 2015 were identified from the SEER database. Multivariate logistic regression was used to analyse factors associated with surgical compliance. Kaplan-Meier curves and Cox regression were used to analyse the effects of surgical compliance on overall survival (OS) and cancer-specific survival (CSS). Results: Of the 221,704 eligible T1-2 NSCLC patients, 106,668 patients recommended surgery. Among them, 99,672 (93.4%) patients were surgical compliance group, and 6996 (6.6%) were surgical noncompliance group. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income. Patients' compliance was an independent prognostic factor for OS and CSS of T1-2 NSCLC patients. Multivariate Cox regression showed that surgical noncompliance individuals showed lower OS (hazard ratio [HR] 2.494; 95% confidence interval [CI] 2.423-2.566, p < 0.001) and lower CSS (HR 2.877; 95% CI 2.782-2.974, p < 0.001) compared with surgical compliance patients. In addition, results in the non-surgical group were observed to be similar to those of the surgical noncompliance group. Conclusion: We found that patients' compliance was an independent prognostic factor for survival in T1-2 NSCLC patients. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/ stage, and lower household income.
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