Yuqian Feng, Kaibo Guo, Huimin Jin, Yuying Xiang, Yiting Zhang, Shanming Ruan
The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland)
Med Sci Monit 2020; 26:e923931
Available online: 2020-06-18
The study was intended to establish predictive nomogram models for predicting total early mortality (the probability of surviving less than or equal to 3 months) and cancer-specific early mortality in patients with stage IV gastric cancer. This was the first study to establish prognostic survival in patients with stage IV gastric cancer.
MATERIAL AND METHODS: Patients from the SEER database were identified using inclusion and exclusion criteria. Their clinical characteristics were statistically analyzed. The Kaplan-Meier method and the log-rank test were used to compare the influences of different factors on survival time. Logistic regression models were conducted to explore the correlative factors of early mortality. A nomogram was established based on factors significant in the logistic regression model and an internal validation was performed.
RESULTS: Of the 11,036 eligible patients included in the study, 4932(44.7%) patients resulted in total early death (42.6% died of the cancer and 2.1% died of other reasons). Larger tumor size, poor differentiation, and liver metastasis were positively related to cancer-specific early mortality. Surgery was negatively related to total early mortality and cancer-specific early mortality, while cardia was only negatively associated with total early death. Predictive nomogram models for total early mortality and cancer-specific early mortality have been validated internally. The areas under the receiver operating characteristics curve were 73.5%, and 68.0%, respectively, and the decision curve analysis also proved the value of the models.
CONCLUSIONS: The nomogram models proved to be a suitable tool for predicting the early mortality in stage IV gastric cancer.
Keywords: Mortality, Premature, nomograms, Stomach Neoplasms