Multi‑institutional development and validation of a nomogram to predict prognosis of early-onset gastric cancer patients

作者：Hongda Liu, Zequn Li, Qun Zhang, Qingya Li, Hao Zhong, Yawen Wang, Hui Yang, Hui Li, Xiao Wang, Kangshuai Li, Dehai Wang, Xiangrong Kong, Zhongyuan He, Weizhi Wang, Linjun Wang, Diancai Zhang, Hao Xu, Yang Li, Yuxin Chen, Yanbing Zhou, Zekuan Xu · 发表于：Frontiers in Immunology · 年份：2022 · DOI：10.3389/fimmu.2022.1007176 · 被引用次数：43 · 研究领域：Gastric Cancer Management and Outcomes、Helicobacter pylori-related gastroenterology studies、Esophageal Cancer Research and Treatment

Background: Early-onset gastric cancer (EOGC, ≤45 years old) is characterized with increasing incidence and more malignant phenotypes compared with late-onset gastric cancer, which exhibits remarkable immune cell infiltration and is potential immunotherapeutic population. Till now, restricted survival information of EOGC is available due to limited case numbers. This study established a novel nomogram to help evaluate cancer-specific survival (CSS) of EOGC patients who underwent gastrectomy, and may provide evidence for predicting patients' survival. Methods: We retrospectively enrolled a cohort containing 555 EOGC cases from five independent medical centers in China, among which 388 cases were randomly selected into a training set while the other 167 cases were assigned into the internal validation set. Asian or Pacific Islander (API) patients diagnosed with EOGC during 1975-2016 were retrieved from the SEER database (n=299) and utilized as the external validation cohort. Univariate and multivariate analyses were conducted to test prognostic significances of clinicopathological factors in the training set. Accordingly, two survival nomogram models were established and compared by concordance index (C-index), calibration curve, receiver operating characteristics (ROC) curves and decision curve analyses (DCA). Results: The 5-year CSS rate of training cohort was 61.3% with a median survival time as 97.2 months. High consistency was observed on calibration curves in all three co...