Model established based on blood markers predicts overall survival in patients after radical resection of types Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction

BACKGROUND In recent years, the incidence of types Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction(AEG) has shown an obvious upward trend worldwide. The prognostic prediction after radical resection of AEG has not been well established.AIM To establish a prognostic model for AEG(types II and III) based on routine markers.METHODS A total of 355 patients who underwent curative AEG at The First Affiliated Hospital of Anhui Medical University from January 2014 to June 2015 were retrospectively included in this study. Univariate and multivariate analyses were performed to identify the independent risk factors. A nomogram was constructed based on Cox proportional hazards models. The new score models was analyzed by C index and calibration curves. The receiver operating characteristic(ROC) curve was used to compare the predictive accuracy of the scoring system and tumor-node-metastasis(TNM) stage. Overall survival was calculated using the Kaplan-Meier curve amongst different risk AEG patients.RESULTS Multivariate analysis showed that TNM stage(hazard ratio [HR] = 2.286, P = 0.008), neutrophil-tolymphocyte ratio(HR = 2.979, P = 0.001), and body mass index(HR = 0.626, P = 0.026) were independent prognostic factors. The new scoring system had a higher concordance index(0.697),and the calibration curves of the nomogram were reliable. The area under the ROC curve of the new score model(3-year: 0.725, 95% confidence interval [CI]: 0.676-0.777;5-year: 0.758, 95%CI:0.708-0.807) was larger than that of TNM staging(3-year: 0.630, 95%CI: 0.585-0.684;5-year: 0.665,95%CI: 0.616-0.715).CONCLUSION Based on the serum markers and other clinical indicators, we have developed a precise model to predict the prognosis of patients with AEG(types II and III). The new prognostic nomogram could effectively enhance the predictive value of the TNM staging system. This scoring system can be advantageous and helpful for surgeons and patients.

Nomogram established using risk factors of early gastric cancer for predicting the lymph node metastasis

BACKGROUND For the prognosis of patients with early gastric cancer(EGC),lymph node metastasis(LNM)plays a crucial role.A thorough and precise evaluation of the patient for LNM is now required.AIM To determine the factors influencing LNM and to construct a prediction model of LNM for EGC patients.METHODS Clinical information and pathology data of 2217 EGC patients downloaded from the Surveillance,Epidemiology,and End Results database were collected and analyzed.Based on a 7:3 ratio,1550 people were categorized into training sets and 667 people were assigned to testing sets,randomly.Based on the factors influencing LNM determined by the training sets,the nomogram was drawn and verified.RESULTS Based on multivariate analysis,age at diagnosis,histology type,grade,T-stage,and size were risk factors of LNM for EGC.Besides,nomogram was drawn to predict the risk of LNM for EGC patients.Among the categorical variables,the effect of grade(well,moderate,and poor)was the most significant prognosis factor.For training sets and testing sets,respectively,area under the receiver-operating characteristic curve of nomograms were 0.751[95%confidence interval(CI):0.721-0.782]and 0.786(95%CI:0.742-0.830).In addition,the calibration curves showed that the prediction model of LNM had good consistency.CONCLUSION Age at diagnosis,histology type,grade,T-stage,and tumor size were independent variables for LNM in EGC.Based on the above risk factors,prediction model may offer some guiding implications for the choice of subsequent therapeutic approaches for EGC.