He JY, Cao MX, Li EZ, Hu C, Zhang YQ, Zhang RL, Cheng XD, Xu ZY. Development and validation of a nomogram for predicting lymph node metastasis in early gastric cancer. World J Gastrointest Oncol 2024; 16(7): 2960-2970 [PMID: 39072177 DOI: 10.4251/wjgo.v16.i7.2960]
Corresponding Author of This Article
Zhi-Yuan Xu, MD, Chief Doctor, Department of Gastric Surgery, Zhejiang Cancer Hospital, No. 1 Banshan East Road, Gongshu District, Hangzhou 310006, Zhejiang Province, China. getfar@foxmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
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He JY, Cao MX, Li EZ, Hu C, Zhang YQ, Zhang RL, Cheng XD, Xu ZY. Development and validation of a nomogram for predicting lymph node metastasis in early gastric cancer. World J Gastrointest Oncol 2024; 16(7): 2960-2970 [PMID: 39072177 DOI: 10.4251/wjgo.v16.i7.2960]
Jing-Yang He, Meng-Xuan Cao, En-Ze Li, Can Hu, Yan-Qiang Zhang, Ruo-Lan Zhang, Xiang-Dong Cheng, Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou 310022, Zhejiang Province, China
Zhi-Yuan Xu, Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou 310006, Zhejiang Province, China
Co-corresponding authors: Xiang-Dong Cheng and Zhi-Yuan Xu.
Author contributions: Xu ZY and Hu C designed the research study; Li EZ, Zhang YQ, and Zhang RL performed the primary literature search and data collection; He JY and Cao MX analyzed the data and wrote the manuscript; Cheng XD and Xu ZY revised the manuscript for important intellectual content; Xu ZY and Cheng XD contributed equally to this work and as such are co-corresponding authors of this manuscript; All authors read and approved the final version.
Supported bythe 14th Five-Year Plan National Key R&D Program, No. 2021YFA0910100; Zhejiang Upper Gastrointestinal Cancer Diagnosis and Treatment Technology Research Center, No. JBZX-202006; Zhejiang Provincial Medical and Health Program-Provincial and Ministerial Joint Construction Project, No. WKJ-ZJ-2104; and the National Natural Science Foundation of China, No. 82074245 and No. 81973634.
Institutional review board statement: This study was undertaken in accordance with the World Medical Association-Declaration of Helsinki-ethical principles for medical research, and was designed as a single-center, retrospective study approved by the Medical Ethics Committee of Zhejiang Cancer Hospital (IRB-2022-371).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Due to the privacy of patients, the data related to patients cannot be available for public access but can be obtained from the corresponding author on reasonable request approved by the institutional review board of all enrolled centers.
Corresponding author: Zhi-Yuan Xu, MD, Chief Doctor, Department of Gastric Surgery, Zhejiang Cancer Hospital, No. 1 Banshan East Road, Gongshu District, Hangzhou 310006, Zhejiang Province, China. getfar@foxmail.com
Received: April 10, 2024 Revised: May 9, 2024 Accepted: May 28, 2024 Published online: July 15, 2024 Processing time: 93 Days and 2.6 Hours
Abstract
BACKGROUND
Lymph node metastasis (LNM) significantly impacts the treatment and prognosis of early gastric cancer (EGC). Consequently, the precise prediction of LNM risk in EGC patients is essential to guide the selection of appropriate surgical approaches in clinical settings.
AIM
To develop a novel nomogram risk model for predicting LNM in EGC patients, utilizing preoperative clinicopathological data.
METHODS
Univariate and multivariate logistic regression analyses were performed to examine the correlation between clinicopathological factors and LNM in EGC patients. Additionally, univariate Kaplan-Meier and multivariate Cox regression analyses were used to assess the influence of clinical factors on EGC prognosis. A predictive model in the form of a nomogram was developed, and its discrimination ability and calibration were also assessed.
RESULTS
The incidence of LNM in the study cohort was 19.6%. Multivariate logistic regression identified tumor size, location, degree of differentiation, and pathological type as independent risk factors for LNM in EGC patients. Both tumor pathological type and LNM independently affected the prognosis of EGC. The model’s performance was reflected by an area under the curve of 0.750 [95% confidence interval (CI): 0.701-0.789] for the training group and 0.763 (95%CI: 0.687-0.838) for the validation group.
CONCLUSION
A clinical prediction model was constructed (using tumor size, low differentiation, location in the middle-lower region, and signet ring cell carcinoma), with its score being a significant prognosis indicator.
Core Tip: Early gastric cancer (EGC) refers to adenocarcinoma in which the cancer tissue is limited to the gastric mucosa or submucosa, regardless of tumor size and lymph node metastasis (LNM). It is very important to accurately predict the risk of LNM, and understanding the metastatic status of lymph nodes in EGC is conducive to selecting the appropriate surgical method and improving the overall efficacy of treatment.
