Nomogram based on clinical characteristics for predicting overall survival in gastric cancer patients with preoperative anemia

Table 1 Clinical features of patients in two groups

Characteristic	Total cohort, n = 347	Training cohort, n = 243	Validation cohort, n = 104
Age, yr
< 73	233 (67.1%)	75 (72.1%)	158 (65.0%)
≥ 73	114 (32.9%)	85 (35.0%)	29 (27.9%)
Sex
Female	89 (25.6%)	60 (24.7%)	29 (27.9%)
Male	258 (74.4%)	183 (75.3%)	75 (72.1%)
Tumor size, cm
< 3.5	93 (26.8%)	64 (26.3%)	29 (27.9%)
≥ 3.5	254 (73.2%)	179 (73.7%)	75 (72.1%)
Stage
I	61 (17.6%)	42 (17.3%)	19 (18.3%)
II	83 (23.9%)	61 (25.1%)	22 (21.1%)
III	181 (52.1%)	125 (51.4%)	56 (53.8%)
IV	24 (6.3%)	15 (6.2%)	7 (6.7%)
Liver metastasis
No	326 (94.0%)	227 (93.4%)	99 (95.2%)
Yes	21 (6.0%)	16 (6.6%)	5 (4.8%)
Lymphocyte count, × 109/L
< 1.2	134 (38.6%)	101 (41.6%)	33 (31.7%)
≥ 1.2	213 (61.4%)	142 (58.4%)	71 (68.3%)
AFP, ng/mL
< 2.6	205 (59.1%)	143 (58.8%)	62 (59.6%)
≥ 2.6	142 (40.9%)	100 (41.2%)	42 (43.1%)
Type of surgery
Partial excision	191 (55.0%)	130 (53.4%)	61 (58.7%)
Total gastrectomy	156 (45.0%)	113 (46.6%)	43 (41.3%)
GC type
Ulcer type	289 (83.3%)	207 (85.1%)	82 (78.8%)
Polyp type	26 (7.5%)	16 (6.6%)	10 (9.6%)
Diffuse type	11 (3.2%)	8 (3.3%)	3 (2.9%)
Others	21 (6.0%)	12 (5.0%)	9 (8.7%)
Peritoneal metastasis
No	322 (92.8%)	226 (93.1%)	96 (92.3%)
Yes	25 (7.2%)	17 (6.9%)	8 (7.7%)
Lymphatic metastasis
No	95 (27.4%)	64 (26.6%)	31 (29.8%)
Yes	252 (72.6%)	179 (73.4%)	73 (70.2%)
Remote metastasis
No	323 (93.1%)	228 (93.8%)	95 (91.3%)
Yes	24 (6.9%)	15 (6.2%)	9 (8.9%)
Vascular invasion
No	195 (56.2%)	136 (66.0%)	59 (56.7%)
Yes	152 (43.8%)	107 (44.0%)	45 (43.3%)
Histological differentiation
Highly or moderately differentiated	98 (28.2%)	70 (28.85)	28 (26.9%)
Lowly or undifferentiated	222 (64.0%)	155 (63.8%)	67 (64.4%)
Indolent cell or mucinous adenocarcinoma
Monocyte count, × 109/L	27 (7.8%)	18 (7.4%)	9 (8.7%)
< 0.47
≥ 0.47	172 (49.6%)	101 (41.6%)	71 (68.3%)
Red cell distribution width, %	175 (50.4%)	142 (58.4%)	33 (31.7%)
< 18.9	307 (88.5%)	216 (88.9%)	91 (87.5%)
≥ 18.9	40 (11.5%)	27 (11.1%)	13 (12.5%)
Red blood cell specific volume, L/L
< 0.34	266 (76.7%)	192 (79.0%)	74 (71.2%)
≥ 0.34	81 (23.3%)	51 (21.0%)	30 (28.8%)
Mean corpuscular hemoglobin, pg
< 30.70	297 (85.6%)	211 (86.8%)	86 (82.7%)
≥ 30.70	50 (14.4%)	32 (13.2%)	18 (17.3%)
Mean corpuscular volume, fL
< 87.30	187 (53.9%)	134 (55.1%)	53 (51.0%)
≥ 87.30	160 (46.1%)	109 (44.9%)	51 (49.0%)

AFP: Alpha-fetoprotein.

Table 2 Univariate and multivariate Cox analyses of overall survival in patients with preoperatively anemic gastric cancer

	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Age, yr
< 73
≥ 73	1.886 (1.367-2.602)	< 0.001	2.137 (1.532-2.981)	< 0.001
Sex
Female
Male	1.365 (0.924-2.016)	0.118
Tumor size, cm
< 3.5
≥ 3.5	2.399 (1.561-3.685)	< 0.001
Stage
I
II	2.274 (1.142-4.526)	0.019	1.726 (0.846-3.521)	0.133
III	5.296 (2.827-9.919)	< 0.001	4.231 (2.192-8.167)	< 0.001
IV	14.598 (6.501-32.780)	< 0.001	4.908 (1.426-16.897)	< 0.001
Liver metastasis
No
Yes	5.046 (2.943-8.653)	0.001	3.573 (1.302-9.804)	0.013
Monocyte count, × 109/L
< 0.47
≥ 0.47	2.006 (1.363-2.953)	0.019	1.819 (1.225-2.700)	0.003
Lymphocyte count, × 109/L
< 1.2
≥ 1.2	0.683 (0.498-0.939)	< 0.001	0.645 (0.463-0.898)	0.009
AFP, ng/mL
< 2.6
≥ 2.6	1.983 (1.443-2.725)	< 0.001	1.720 (1.238-2.390)	0.001
Type of surgery
Partial excision
Total Gastrectomy	1.292 (0.940-1.775)	0.114
GC type
Ulcer type
Polyp type	0.97 (0.475-1.979)	0.933	1.527 (0.736-3.167)	0.225
Diffuse type	2.715 (1.256-5.869)	0.011	5.131 (2.266-11.621)	< 0.01
Others	0.17 (0.042-0.687)	0.013	0.353 (0.082-1.517)	0.162
Peritoneal metastasis
No
Yes	3.531 (2.086-5.595)	< 0.001
Lymphatic metastasis
No
Yes	2.879 (1.857-4.465)	< 0.001
Vascular invasion
No
Yes	1.831 (1.332-2.519)	< 0.001
Histological differentiation
Highly or moderately differentiated
Lowly or
undifferentiated	1.848 (1.255-2.271)	0.002
Indolent cell or mucinous adenocarcinoma	1.363 (0.690-2.691)	0.372
Red cell distribution width, %
< 18.9
≥ 18.9	1.88 (1.203-2.938)	0.006
Red blood cell specific volume, L/L
< 0.34
≥ 0.34	1.505 (0.98-2.31)	0.062
Mean corpuscular hemoglobin, pg
< 30.7
≥ 30.7	0.838 (0.674-1.042)	0.112
Mean corpuscular volume, fL
< 87.30
≥ 87.30	1.114 (0.948-1.309)	0.189

HR: Hazard ratio; AFP: Alpha-fetoprotein.