Log-normal censored regression model detecting prognostic factors in gastric cancer: A study of 3018 cases

doi:10.3748/wjg.v17.i23.2867

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jun 21, 2011; 17(23): 2867-2872
Published online Jun 21, 2011. doi: 10.3748/wjg.v17.i23.2867

Table 1 Clinicopathological characteristics of 3018 gastric cancers included in the study n (%)

Variable	Subgroups	Frequency
Gender ratio	Male	2211 (73.26)
	Female	807 (26.74)
Age at diagnosis (mean ± SD; yr)		57.54 ± 11.24
Past history
	Without	2234 (74.02)
	With	784 (25.98)
Family history	Without	2467 (81.74)
	With	551 (18.26)
Cancer number	Single	2883 (96.65)
	Multiple	100 (3.35)
Cancer location	Lower stomach	1873 (62.64)
	Middle stomach	492 (16.46)
	Upper stomach	355 (11.87)
	Total stomach	270 (9.03)
Distant metastasis status	Without	2540 (85.04)
	With	447 (14.96)
Maximum tumor diameter (mean ± SD, cm)		5.85 ± 3.30
Surgical curative degree	Absolutely radical	1396 (49.73)
	Relatively radical	809 (28.82)
	Palliative	602 (21.45)
Lymph node dissection	More than D2	608 (20.99)
	D2	1362 (47.03)
	D1	269 (9.29)
	Palliative surgery	657 (22.69)
Combined other organ resection	Without	2016 (76.80)
	With	609 (23.20)
Histological type	Well differentiated	755 (27.43)
	Middle differentiated	382 (13.88)
	Poor differentiated	1615 (58.69)
Borrmann classification	I	70 (2.98)
	II	426 (18.15)
	III	1571 (66.94)
	IV	280 (11.93)
Lauren classification	Intestinal type	1170 (43.89)
	Diffuse type	1496 (56.11)
pT stage	pT1	328 (11.89)
	pT2	1486 (53.88)
	pT3	737 (26.72)
	pT4	207 (7.51)
Total dissected lymph node (mean ± SD)		15.27 ± 13.11
Pathological lymph node status	pN0	1375 (45.56)
	pN1	1039 (34.43)
	pN2	432 (14.31)
	pN3	172 (5.70)

Table 2 Univariate model of Cox and log normal regression with prognostic factors

	HR (95% CI)
	Cox	Log normal
Sex
Male	0.953 (0.843-1.078)	0.925 (0.818-1.046)
Female	1.00	1.00
Age at diagnosis	1.015¹ (1.009-1.020)	1.016¹ (1.011-1.021)
Past history
Without	1.00	1.00
With	0.715¹ (0.631-0.831)	0.694¹ (0.612-0.787)
Family history
Without	1.00	1.00
With	0.871 (0.752-1.009)	0.875 (0.754-1.014)
Cancer number
Single	1.00	1.00
Multiple	0.870 (0.622-1.218)	0.924 (0.661-1.294)
Cancer location
Lower third	1.00	1.00
Middle third	1.181¹ (1.017-1.373)	1.302¹ (1.233-1.374)
Upper third	1.436¹ (1.212-1.701)	1.695¹ (1.429-1.897)
Total stomach	2.464¹ (2.062-2.944)	2.207¹ (2.011-2.677)
Distant metastasis
Absent	1.00	1.00
Present	2.554¹ (2.194-2.973)	2.596¹ (2.227-3.027)
Surgical curative degree
Absolutely radical	1.00	1.00
Relatively radical	1.835¹ (1.593-2.114)	2.159¹ (2.020-2.308)
Palliative	4.236¹ (3.714-4.832)	4.661¹ (4.214-4.759)
Lymph node dissection
> D2	1.00	1.00
D2	0.989 (0.859-1.138)	1.536¹ (1.458-1.619)
D1	1.056 (0.853-1.307)	2.359¹ (2.121-2.574)
< D1	3.310¹ (2.854-3.839)	3.624¹ (3.231-3.862)
Combined other organ resection
Without	1.00	1.00
With	1.981¹ (1.749-2.245)	2.070¹ (1.825-2.348)
Histologic types
Well differentiated	1.00	1.00
Middle differentiated	0.706¹ (0.592-0.843)	0.976 (0.918-1.039)
Poor differentiated	0.918 (0.814-1.036)	0.952 (0.897-1.011)
Borrmann classification (n (%))
I	1.00	1.00
II	1.005 (0.892-1.340)	0.981 (0.894-1.019)
III	1.247¹ (1.173-1.638)	1.176¹ (1.074-1.293)
IV	2.512¹ (1.842-3.075)	2.610¹ (2.416-3.153)
Lauren classification (n (%))
Intestinal type	1.00	1.00
Diffuse type	1.245¹ (1.082-1.184)	1.171¹ (1.015-1.384)
pT stage
pT1	1.00	1.00
pT2	2.936¹ (2.299-3.751)	1.787¹ (1.666-1.916)
pT3	4.305¹ (3.357-5.522)	3.193¹ (3.066-3.321)
pT4	7.697¹ (5.759-10.287)	5.707¹ (5.579-5.833)
Total dissected nodes	0.993¹ (0.988-0.998)	0.994¹ (0.988-0.998)
pN stage
pN0	1.00	1.00
pN1	1.555¹ (1.372-1.764)	1.633¹ (1.533-1.740)
pN2	2.510¹ (2.133-2.953)	2.667¹ (2.561-2.772)
pN3	3.669¹ (2.901-4.640)	4.355¹ (4.249-4.460)

¹Statistically significant (P < 0.05). HR: Hazard radio; CI: Confidence interval.

Table 3 Multivariate model of Cox and log normal regression with prognostic factors (full model and final model)

	Cox HR (95% CI)		Log normal HR (95% CI)
	Full model (AIC = 1508.49)	Final model (AIC = 2534.72)	Full model (AIC = 913.34)	Final model (AIC = 1693.56)
Sex
Male	0.91 (0.801-1.034)		0.886 (0.781-1.005)
Female	1.00
Age at diagnosis	1.014¹ (1.009-1.02)	1.011¹ (1.006-1.017)	1.015¹ (1.010-1.021)	1.015¹ (1.009-1.020)
Past history
Without	1.00	1.00	1.00	1.00
With	0.840¹ (0.738-0.955)	0.858¹ (0.755-0.975)	0.813¹ (0.716-0.914)	0.809¹ (0.713-0.919)
Family history
Without	1.00		1.00	1.00
With	0.957 (0.8254-1.11)		0.967 (0.833-1.234)
Cancer number
Single	1.00		1.00
Multiple	1.21 (0.861-1.701)		1.312 (1.935-1.840)
Cancer location
Lower third	1.00		1.00	1.00
Middle third	1.033 (0.885-1.205)		1.135¹ (1.073-1.199)	1.129¹ (1.069-1.194)
Upper third	1.406¹ (1.173-1.686)		1.288¹ (1.224-1.353)	1.277¹ (1.211-1.338)
Total stomach	1.466¹ (1.214-1.771)		1.462¹ (1.365-1.558)	1.439¹ (1.343-1.535)
Distant metastasis
Absent	1.00		1.00	1.00
Present	1.21¹ (1.013-1.447)		1.205¹ (1.011-1.437)	1.198¹ (1.009-1.424)
Surgical curative degree
Absolutely radical	1.00	1.00	1.00	1.00
Relatively radical	1.389¹ (1.197-1.611)	1.383¹ (1.194-1.601)	1.724¹ (1.537-1.934)	1.672¹ (1.538-1.817)
Palliative	3.889¹ (2.583-5.855)	2.687¹ (2.316-3.116)	2.972¹ (2.770-3.174)	2.796¹ (2.653-2.938)
Lymph node dissection
> D2	1.00		1.00
D2	0.908 (0.784-1.051)		0.967 (0.892-1.049)
D1	0.901 (0.712-1.14)		0.935 (0.855-1.015)
< D1	0.607¹ (0.395-0.935)		0.904 (0.784-1.024)
Combined other organ resection
Without	1.00		1.00
With	1.406¹ (1.227-1.61)		1.447¹ (1.264-1.657)
Histologic types
Well differentiated	1.00		1.00	1.00
Middle differentiated	1.056 (0.878-1.271)		1.110¹ (1.042-1.183)	1.120¹ (1.051-1.193)
Poor differentiated	1.179¹ (1.035-1.343)		1.232¹ (1.160-1.304)	1.254¹ (1.182-1.327)
Borrmann classification
I	1.00	1.00	1.00	1.00
II	1.142 (0.957-1.319)	1.201 (1.068-1.433)	1.018 (0.943-1.106)	1.015 (0.941-1.102)
III	1.315¹ (1.113-1.672)	1.394¹ (1.205-1.741)	1.246¹ (1.052-1.539)	1.241¹ (1.047-1.533)
IV	2.126¹ (1.758-3.119)	2.253¹ (1.827-3.284)	2.530¹ (2.376-2.713)	2.526¹ (2.372-2.708)
Lauren classification
Intestinal type	1.00		1.00	1.00
Diffuse type	1.131¹ (1.012-1.358)		1.307¹ (1.154-1.528)	1.302¹ (1.148-1.523)
pT stage
pT1	1.00	1.00	1.00	1.00
pT2	1.851¹ (1.431-2.394)	1.971¹ (1.528-2.542)	1.195¹ (1.102-1.297)	1.193¹ (1.100-1.294)
pT3	1.981¹ (1.511-2.598)	2.19¹ (1.678-2.858)	1.428¹ (1.328-1.527)	1.423¹ (1.324-1.522)
pT4	2.344¹ (1.699-3.235)	2.501¹ (1.821-3.435)	1.706¹ (1.557-1.855)	1.697¹ (1.549-1.847)
Total dissected nodes	0.987¹ (0.981-0.993)		0.988¹ (0.982-0.993)
pN stage
pN0	1.00	1.00	1.00	1.00
pN1	1.281¹ (1.123-1.461)	1.266¹ (1.11-1.444)	1.507¹ (1.393-1.620)	1.500¹ (1.387-1.622)
pN2	2.139¹ (1.783-2.566)	2.095¹ (1.749-2.51)	2.271¹ (2.151-2.391)	2.250¹ (2.130-2.370)
pN3	3.24¹ (2.446-4.292)	3.325¹ (2.52-4.386)	3.422¹ (3.242-3.602)	3.375¹ (3.196-3.554)

¹Statistically significant (< 0.05); HR: Hazard radio; CI: Confidence interval; AIC: Akaike Information Criterion.

Citation: Wang BB, Liu CG, Lu P, Latengbaolide A, Lu Y. Log-normal censored regression model detecting prognostic factors in gastric cancer: A study of 3018 cases. World J Gastroenterol 2011; 17(23): 2867-2872
URL: https://www.wjgnet.com/1007-9327/full/v17/i23/2867.htm
DOI: https://dx.doi.org/10.3748/wjg.v17.i23.2867