Analysis of risk factors of stage IV gastric cancer from the SEER database

Xy, Ge; F, Ge; Wang, Z; Wang, Yuliang; Lw, Lei; Qr, Liu; Sun, Xi; Jiang, Xian

doi:10.1308/rcsann.2020.0031

Cited by 4 publications

(2 citation statements)

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“…GC is a major cause of cancer mortality worldwide (1), and the clinical stage is one of the key factors affecting the prognosis (13)(14)(15). Although many previous studies have investigated the prognosis of patients with stage IV GC (9,(16)(17)(18)(19), little is known about early death. To the best of our knowledge, the present study is the first to explore the early mortality and associated factors among stage IV GC patients.…”

Section: Discussionmentioning

confidence: 99%

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Chen

2020

J Gastrointest Oncol

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Background: Although advances in the treatment of stage IV gastric cancer (GC) patients, some patients were observed to die within 3 months of initial diagnosis. The present study aimed to explore the early mortality and risk factors for stage IV GC and further develop nomograms.Methods: A total of 2,174 eligible stage IV GC patients were selected from the Surveillance, Epidemiology, and End Results database. Logistic regression analyses were used to determine the risk factors and develop the nomograms to predict all-cause early death and cancer-specific early death. The predictive performance of the nomograms was assessed by receiver operating characteristic curves (ROC), calibration plots and decision curve analyses (DCA) in both training and validation cohorts.Results: Of 2,174 patients enrolled, 708 died within 3 months of initial diagnosis (n=668 for cancerspecific early death). Early mortality remained stable from 2010-2015. Non-Asian or Pacific Islander (API) race, poorer differentiation, middle sites of the stomach, no surgery, no radiotherapy, no chemotherapy, lung metastases and liver metastases were associated with high risk of both all-causes early death and cancerspecific early death. The nomograms constructed based on these factors showed favorable sensitivity, with the area under the ROC range of 0.816-0.847. The calibration curves and DCAs also exhibited adequate fit and ideal net benefit in prediction and clinical application.Conclusions: Approximately one-third of stage IV GC patients experienced early death. These associated risk factors and predictive nomograms may help clinicians identify the patients at high risk of early death and be the reference for treatment choices.

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Section: Discussionmentioning

confidence: 99%

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Chen

2020

J Gastrointest Oncol

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“…Moreover, tumor size, tumor stage, and tumor grade are all prognostic factors for gastric cancer patients ( 27 ). Surgery is also an important prognostic factor for gastric cancer patients ( 28 ). The following characteristics were found to be independent predictive factors in this study and were incorporated in the model: tumor grade, stage T, stage N, stage M, primary location, and surgery at primary site.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a novel nomogram to predict cancer-specific survival in patients with gastric adenocarcinoma

Nie

Zhang²,

Yan³

et al. 2023

Front. Oncol.

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Background and aimsAdenocarcinoma is one of the most common pathological types of gastric cancer. The aims of this study were to develop and validate prognostic nomograms that could predict the probability of cancer-specific survival (CSS) for gastric adenocarcinoma (GAC) patients at 1, 3, and 5 years.MethodsIn total, 7747 patients with GAC diagnosed between 2010 and 2015, and 4591 patients diagnosed between 2004 and 2009 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. The 7747 patients were used as a prognostic cohort to explore GAC-related prognostic risk factors. Moreover, the 4591 patients were used for external validation. The prognostic cohort was also divided into a training and internal validation sets for construction and internal validation of the nomogram. CSS predictors were screened using least absolute shrinkage and selection operator regression analysis. A prognostic model was built using Cox hazard regression analysis and provided as static and dynamic network-based nomograms.ResultsThe primary site, tumor grade, surgery of the primary site, T stage, N stage, and M stage were determined to be independent prognostic factors for CSS and were subsequently included in construction of the nomogram. CSS was accurately estimated using the nomogram at 1, 3, and 5 years. The areas under the curve (AUCs) for the training group at 1, 3, and 5 years were 0.816, 0.853, and 0.863, respectively. Following internal validation, these values were 0.817, 0.851, and 0.861. Further, the AUC of the nomogram was much greater than that of American Joint Committee on Cancer (AJCC) or SEER staging. Moreover, the anticipated and actual CSS values were in good agreement based on decision curves and time-calibrated plots. Then, patients from the two subgroups were divided into high- and low-risk groups based on this nomogram. The survival rate of high-risk patients was considerably lower than that of low-risk patients, according to Kaplan–Meier (K-M) curves (p<0.0001).ConclusionsA reliable and convenient nomogram in the form of a static nomogram or an online calculator was constructed and validated to assist physicians in quantifying the probability of CSS in GAC patients.

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Nomogram for predicting overall survival in metastatic gastric cancer: a population-based study from SEER

Wang

2022

Preprint

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Background Gastric cancer is a highly malignant tumor, and many patients already have distant metastasis at the time of diagnosis, so the mortality rate is very high. It is necessary to establish an effective prognostic prediction model to guide treatment. Methods The cases diagnosed as metastatic gastric cancer from 2010 to 2018 in Surveillance Epidemiology and End Results (SEER) database were selected, and the clinicopathological characteristics were included in the cox regression model to determine which are the independent factors affecting prognosis. Then all cases were divided into training cohort and verification cohort. A nomogram for predicting overall survival (OS) was established using the training cohort, and the effectiveness was verified with the verification cohort. Result A total of 4208 stage IV gastric cancer patients were enrolled in this study. firstly, they were randomly divided into training cohort and verification cohort according to the proportion of 2:1. The median overall survival was 8 (95% CI 7.6–8.4) months in the training cohort. Age at diagnosis, gender, histology grade, T stage, N stage, surgery for primary site, performance of chemotherapy or radiotherapy, existence of bone, liver or lung metastasis were independent prognostic factors. Then a nomogram was established using the training cohort (2948), and the concordance index (C index) is calculated as 0.696 (95%CI 0.684–0.708). It was also found that the model has good prediction ability by using the calibration chart. ROC curve showed that the model can accurately predict the OS, AUC of 1 year, 3 years and 5 years survival are 0.7, 0.756 and 0.76365 respectively. Finally, the calibration chart and ROC curve were used in the verification cohort to prove these results. Conclusion In this study, based on the data of patients with metastatic gastric cancer in SEER database, a nomogram which can predict overall survival was established, from which several independent prognostic factors were verified. C index, ROC curve and calibration chart were used to verify the effectiveness of the nomogram, which can provide a reference for predicting prognosis and guiding individualized treatment for advanced gastric cancer patients.

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Analysis of risk factors of stage IV gastric cancer from the SEER database

Cited by 4 publications

References 16 publications

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Construction and validation of a novel nomogram to predict cancer-specific survival in patients with gastric adenocarcinoma

Nomogram for predicting overall survival in metastatic gastric cancer: a population-based study from SEER

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