scholarly journals The Research and Analysis of Bring Perigastric Tumor Deposits into The Staging of Primary Gastric Cancer

2020 ◽  
Author(s):  
xinxin wang ◽  
zhaoyang wang ◽  
tianyu xie ◽  
shuo li ◽  
di wu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Model ◽  
Cox Regression ◽  
Survival Curve ◽  
Statistical Significance ◽  
Tnm Staging ◽  
Gastric Body ◽  
Rank Test ◽  
Binary Logistic Regression Model ◽  
Primary Gastric Cancer

Abstract Background: The current significance of perigastric tumor deposits (TDs) in gastriccancer (GC) for indicating prognosis remains unclear. The aim of this study was to assess the prognostic value of perigastric TDs and a new TNM staging involving TDs for GC.Methods: The pathological data of 6672 patients with GC who underwent gastrectomy or operation of gastric cancer with other diseases between January 1, 2012 and December31, 2017 at Chinese PLA General Hospital were analyzed retrospectively. The patients were divided into tumor deposits positive (TD+) group and tumor deposits negative (TD-) group. The differences between TD+ and TD- were analyzed by binary Logistic regression model. To draw survival curves, we used Kaplan-Meier methods. Multivariate Cox regression model and Log-rank test was used to analyze the data.Results:Perigastric TDs were found to be positive in 339 (5.09%) of the 6672 patients with GC of which 237were males (69.91%) and 102 females (30.09%) (2.32:1). The median age was 59 years (ranging from 27 to 78 years). No significant differences were detected between the two groups. Univariate and multivariate survival analysis both indicated that GC patients with positive TDs had poorer prognosis than those with negative TDs (p<0.05). The 1-, 3-and 5-year overall survival rates of GC patients with TDswere68.3%, 19.6%, and 11.2%, respectively, and weresignificantly poorer than those of the staged matched control group.There was statistical significance between thelocation of TDs and patient survival in patients with gastric cancer (p＜0.05). A new TNM staging was formulated according to the TDs location.When TDs appear on the gastric body,the original T1, T2, T3stages change to T4a, and T4a, T4b change to T4b;whenTDs appear in the lesser curvature, the previous N0, N1, N2, N3 stage change to N3;when the TDs located in the greater curvature or the distant tissue, the patient should be categorized as M1. After using the new stage, the survival curve of patients with TDs was closer to that of patients without TDs in each pTNM staging.Conclusion: 1. Tumor deposits is a bad prognostic factor in patients with primary gastric cancer. 2. The location of tumor deposits is associated with the prognosis of patients with primary gastric cancer.3.The new stage is more suitable for patients with tumor deposits of gastric cancer.

scholarly journals The Research and Analysis of Bring Perigastric Tumor Deposits into The Staging of Primary Gastric Cancer

2020 ◽  
Author(s):  
Xinxin Wang ◽  
Zhaoyang Wang ◽  
Tianyu Xie ◽  
Shuo Li ◽  
Di Wu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Model ◽  
Cox Regression ◽  
Survival Curve ◽  
Statistical Significance ◽  
Tnm Staging ◽  
Gastric Body ◽  
Rank Test ◽  
Control Group ◽  
Primary Gastric Cancer

Abstract Background: The current significance of perigastric tumor deposits (TDs) in gastric cancer (GC) for indicating prognosis remains unclear. The aim of this study was to assess the prognostic value of perigastric TDs and a new TNM staging involving TDs for GC.Methods: The pathological data of 6672 patients with GC who underwent gastrectomy or operation of gastric cancer with other diseases between January 1, 2012 and December 31, 2017 at Chinese PLA General Hospital were analyzed retrospectively. The patients were divided into tumor deposits positive (TD+) group and tumor deposits negative (TD-) group. The differences between TD+ and TD- were analyzed by binary Logistic regression model. To draw survival curves, we used Kaplan-Meier methods. Multivariate Cox regression model and Log-rank test was used to analyze the data.Results: Perigastric TDs were found to be positive in 339 (5.09%) of the 6672 patients with GC of which 237 were males (69.91%) and 102 females (30.09%) (2.32:1). The median age was 59 years (ranging from 27 to 78 years). No significant differences were detected between the two groups. Univariate and multivariate survival analysis both indicated that GC patients with positive TDs had poorer prognosis than those with negative TDs (p<0.05). The 1-, 3-and 5-year overall survival rates of GC patients with TDs were 68.3%, 19.6%, and 11.2%, respectively, and were significantly poorer than those of the staged matched control group. There was statistical significance between the location of TDs and patient survival in patients with gastric cancer (p＜0.05). A new TNM staging was formulated according to the TDs location. When TDs appear on the gastric body, the original T1, T2, T3 stages change to T4a, and T4a, T4b change to T4b; when TDs appear in the lesser curvature, the previous N0, N1, N2, N3 stage change to N3; when the TDs located in the greater curvature or the distant tissue, the patient should be categorized as M1. After using the new stage, the survival curve of patients with TDs was closer to that of patients without TDs in each pTNM staging.Conclusion: 1. Tumor deposits is a bad prognostic factor in patients with primary gastric cancer. 2. The location of tumor deposits is associated with the prognosis of patients with primary gastric cancer. 3. The new stage is more suitable for patients with tumor deposits of gastric cancer.

scholarly journals The Research and Analysis of Bring Perigastric Tumor Deposits into The Staging of Primary Gastric Cancer

2020 ◽  
Author(s):  
xinxin wang ◽  
zhaoyang wang ◽  
tianyu xie ◽  
shuo li ◽  
di wu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Model ◽  
Cox Regression ◽  
Survival Curve ◽  
Statistical Significance ◽  
Tnm Staging ◽  
Gastric Body ◽  
Rank Test ◽  
Control Group ◽  
Primary Gastric Cancer

Abstract Background: The current significance of perigastric tumor deposits (TDs) in gastric cancer (GC) for indicating prognosis remains unclear. The aim of this study was to assess the prognostic value of perigastric TDs and a new TNM staging involving TDs for GC.Methods: The pathological data of 6672 patients with GC who underwent gastrectomy or operation of gastric cancer with other diseases between January 1, 2012 and December 31, 2017 at Chinese PLA General Hospital were analyzed retrospectively. The patients were divided into tumor deposits positive (TD+) group and tumor deposits negative (TD-) group. The differences between TD+ and TD- were analyzed by binary Logistic regression model. To draw survival curves, we used Kaplan-Meier methods. Multivariate Cox regression model and Log-rank test was used to analyze the data.Results: Perigastric TDs were found to be positive in 339 (5.09%) of the 6672 patients with GC of which 237 were males (69.91%) and 102 females (30.09%) (2.32:1). The median age was 59 years (ranging from 27 to 78 years). No significant differences were detected between the two groups. Univariate and multivariate survival analysis both indicated that GC patients with positive TDs had poorer prognosis than those with negative TDs (p<0.05). The 1-, 3-and 5-year overall survival rates of GC patients with TDs were 68.3%, 19.6%, and 11.2%, respectively, and were significantly poorer than those of the staged matched control group. There was statistical significance between the location of TDs and patient survival in patients with gastric cancer (p＜0.05). A new TNM staging was formulated according to the TDs location. When TDs appear on the gastric body, the original T1, T2, T3 stages change to T4a, and T4a, T4b change to T4b; when TDs appear in the lesser curvature, the previous N0, N1, N2, N3 stage change to N3; when the TDs located in the greater curvature or the distant tissue, the patient should be categorized as M1. After using the new stage, the survival curve of patients with TDs was closer to that of patients without TDs in each pTNM staging.Conclusion: 1. Tumor deposits is a bad prognostic factor in patients with primary gastric cancer. 2. The location of tumor deposits is associated with the prognosis of patients with primary gastric cancer. 3. The new stage is more suitable for patients with tumor deposits of gastric cancer.

HER2-low and gastric cancer: A prognostic biomarker?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16086-e16086
Author(s):  
Bruno Cezar de Mendonça Uchôa ◽  
Rafaela Pirolli ◽  
Luciana Beatriz Mendes Gomes Siqueira ◽  
Francisca Giselle Rocha Moura ◽  
Ana Paula Rondina Correa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Value ◽  
Cox Regression ◽  
Prognostic Biomarker ◽  
Statistical Significance ◽  
Gastroesophageal Junction ◽  
Rank Test ◽  
Cancer Center ◽  
First Line

e16086 Background: The role of HER2 positive (HER2+) as a prognostic biomarker for gastric/gastroesophageal junction cancer (G-GEJC) is controversial. Recently, the HER2-low (HER2l) concept has emerged and proved to predict response to trastuzumab deruxtecan in metastatic scenario. Data on HER2l prognostic value are missing. Methods: All consecutive patients with metastatic G-GEJC, tested for HER2 in the primary tumor or in the metastatic tissue before initiating first-line therapy at A.C. Camargo Cancer Center, were retrospectively recruited. The primary objective was to compare the overall survival (OS: from the metastasis diagnosis to death by any cause) between HER2l and HER2 negative (HER2-) populations. Secondarily, we aimed to compare the first-line progression-free survival (PFS) between HER2l and HER2-, to analyze prognostic factors associated with OS and to compare the OS between HER2+ and HER2l/HER2-. The HER2 immunohistochemistry (IHC) tests were performed with the Ventana anti-HER2/neu kit, by specialized gastrointestinal pathologists of the study center, using the AJCC HER2 scoring criteria for gastric cancer. In situ hybridization (ISH) was done when IHC 2+ was detected. HER2+ were IHC 3+ or 2+ amplified by ISH; HER2l, 1+ or 2+ non-amplified; HER-, 0+. Kaplan-Meier curves, Log-Rank test and Cox regression were used for survival analysis. Cox regression was used for uni and multivariate analysis. Results: From June, 2008 to July, 2020, 398 patients were included (48 HER2+; 103 HER2l; 247 HER2-). The median follow-up was 31 months (m). Median age at diagnosis was 58 years; the majority were men (62.8%), caucasian (50.8%), with gastric (81% vs 19% GEJ), diffuse (50.3%), de novo metastatic (57.0%) tumors. In comparison to HER2l/HER2-, HER2+ group had superior rates of men, GEJC, intestinal subtype and non-visceral metastasis. Central nervous system metastases were uncommon, and proportionally higher in HER2+ tumors (HER2+: 6.2%; HER2l: 2.9%; HER2-: 2.0%; p = 0.27). There were no imbalances between HER2l and HER2- groups. The median OS was similar for HER2l and HER2- (13m for both; HR 1.0, 95%CI 0.76-1.31; p = 1.0), as it was the PFS (5m for both; HR 0.84, 95%CI 0.65-1.08; p = 0.18). These results did not vary on dependence of IHC + (0 vs 1 + vs 2+). HER2+ tumors had a superior median OS (17m vs 13m for HER2l/HER2-; HR 0.70, 95%CI 0.49-0.99; p = 0.046). When ungrouping HER2l/HER2-, this numerical difference remains, with a loss of statistical significance (17m vs 13m vs 13m; HR 0.87, 95%CI 0.74-1.02; p = 0.12). HER2+, > 1 line of treatment and metastasectomy were predictive for improved OS in multivariate analysis. HER2l was neither predictive for OS nor PFS. Conclusions: Although HER2-low emerged as a new predictive biomarker in metastatic gastric cancer, its prognostic value could not be proved in this study, with an absence of impact in OS. HER2+, however, was associated with improved survival.

Risk and Prognosis of Subsequent Primary Gastric Cancer

2022 ◽  
Author(s):  
Rongrong Wei ◽  
Xinyu Du ◽  
Jing Wang ◽  
Qi Wang ◽  
Xiaojie Zhu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Survivors ◽  
Cox Regression ◽  
Prognostic Impact ◽  
Cancer Specific Survival ◽  
Cancer History ◽  
Primary Gastric Cancer ◽  
Actual Observation ◽  
Increased Risk

Introduction: The incidence and prognostic impact of subsequent primary gastric cancer (GC) in a population of other cancer survivors is unclear. We aimed to evaluate susceptibility to subsequent primary GC in cancer survivors and prognosis of GC with prior cancer history. Methods: 2,211 and 23,416 GC cases with and without prior cancer history were retrospectively selected from the Surveillance, Epidemiology and End Results (SEER) database. Potential risk of developing subsequent primary GC was assessed through standardized incidence ratios (SIRs). Cox regression were adopted to analyze the influence of prior cancer history and clinical characteristic factors on the prognosis of subsequent primary GC. A nomogram was established to predict overall survival (OS). Propensity score matching (PSM) was conducted to eliminate possible bias. Results: Compared with general population, cancer survivors had an increased risk of subsequent primary GC (SIR 1.17, 95% CI 1.15-1.20, P<0.05). Prior cancer history was related to poor OS of GC [adjusted hazard ratio (aHR) 1.12, 95% CI 1.06-1.19, P<0.001], but not cancer-specific survival (aHR 0.97, 95% CI 0.89-1.05, P=0.441). In addition, age, grade, stage, year of diagnosis, surgery, TNM stage and tumor size were independent prognostic factors for OS in GC cases with prior cancers. The concordance index of the nomogram was 0.72 (95% CI 0.71-0.74), and calibrate curves showed good agreement between prediction by the nomogram and actual observation. Conclusions: Cancer survivors with increased risk of developing subsequent primary GC should strengthen their monitoring and follow-up to prevent occurrence of subsequent primary gastric cancer.

Association of immune related adverse events with superior outcomes in patients with hepatocellular carcinoma (HCC) treated with nivolumab.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16630-e16630
Author(s):  
Lorena Ostios-Garcia ◽  
David Ramiro-Cortijo ◽  
Mary Linton Bounetheau Peters ◽  
Andrea J. Bullock
Keyword(s):  
Adverse Events ◽  
Cox Regression ◽  
Statistical Significance ◽  
Onset Time ◽  
Progression Free Survival ◽  
Categorical Variables ◽  
Rank Test ◽  
Cancer Outcomes ◽  
Exact Test ◽  
Kaplan Meier

e16630 Background: Nivolumab, an anti-PD1 antibody, is FDA approved in patients (pts) with HCC. Anti-PD-1 promotes hyperstimulation of host immunity and is associated with a spectrum of toxicities known as immune-related adverse events (irAEs). In other malignancies, higher rates of irAEs are associated with improved cancer outcomes. This study shows correlation between irAEs and efficacy in pts with HCC treated with nivolumab. Methods: Demographic and toxicity data were collected retrospectively on all pts with HCC treated with nivolumab at a single institution from Jan 2012 – Sept 2019. Response was evaluated using RECISTv1.1. Adverse events were assessed according to CTCAEv5.0. Categorical variables were assessed by Fisher's exact test. Survival was estimated with the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed by the Cox-regression model. Results: 30 pts were treated; irAEs were detected in 16 (53%). There was no difference in baseline characteristics among those who did and did not experience irAEs (Table). The most frequent irAEs were elevated AST/ALT (n = 7; 44%), rash (n = 4; 25%), and hypothyroid (n = 4; 25%). 3 G3 (rash and transaminitis) and 1 G4 AE (pured red cell apalasia) were observed. Among all pts, overall response rate (RR) and disease control rate (DCR) were 13 and 50%, respectively. Median progression free survival (PFS) and overall survival (OS) were 27 and 56 weeks (w), respectively. The RR and DCR were higher among irAEs vs non-irAEs, although this did not reach statistical significance (RR 25 vs 0%; p = 0.05; DCR 62 vs 35%; p = 0.19). Median PFS and OS were longer in those with irAEs vs non-irAE; PFS 33 vs 16 w (HR: 0.26; CI 95%: 0.076-0.89; p = 0.028); (OS 69 vs 21 w HR: 0.18; CI 95%: 0.05-0.58; p = 0.002). On multivariate analysis, viral etiology was associated with prolonged PFS (p = 0.002) and MELD was associated with reduced OS (p = 0.004). Conclusions: Development of irAEs was associated with prolonged PFS and OS in pts with HCC treated with nivolumab. Further study is needed to determine whether type of irAE, onset time, or duration affect cancer outcomes. [Table: see text]

scholarly journals Lymph Node Maximum Uptake of 18F-ALF-NOTA-PRGD2 II PET/CT Predicts Lung Cancer Survival

2020 ◽  
Author(s):  
Yuchun Wei ◽  
Li Ma ◽  
Jinsong Zheng ◽  
Yanqing Pei ◽  
Xueting Qin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cox Regression ◽  
Early Stage ◽  
Statistical Significance ◽  
Tnm Staging ◽  
Tnm Stage ◽  
Receiver Operating Curve ◽  
Cox Regression Analysis ◽  
Pet Ct

Abstract Background:Tumor angiogenesis plays a key role in tumor growth, development, and metastasis, so the exploratory study of tumor neovascularization imaging is one of the potential methods to predict survival. This study aims to examine the predictive capacity of 18F-ALF-NOTA-PRGD2 II (denoted 18F-Alfatide II) positron emission tomography (PET)/computed tomography (CT) before antitumor therapy (ATR) in patients with lung cancer.Results The median follow-up was 31 (1.3~57.0) months. Among the patients, 6 were lost to follow-up. The overall survival (OS) and progression-free survival (PFS) were 40.0 (3.50~57.0) months and 21.30 (2.0~56.0) months, respectively. The maximum uptake values (SUVmax) of the metastatic lymph nodes (SUVLN) and tumor node metastasis (TNM) staging were significant predictors of PFS and OS (all P<0.05) in a multivariate Cox regression analysis. Statistical significance was not reached by any other variable in the multivariate analysis. Receiver operating curve (ROC) analysis for survival revealed an area under the curve of 0.93 (P<0.001) for SUVLN and 0.96 for the TNM stage (P<0.001). The SUVLN and TNM stage cutoff values were 2.50 and II, and their sensitivity, specificity and positive and negative prediction were 77.42%, 80.0% and 82.76% and 74.07%; and 87.10%, 60.0% and 72.97% and 78.95%, respectively. Patients with a lower SUVLN and early stage had a longer PFS and OS (all P<0.05).Conclusions For lung cancer, low SUVLN and an early TNM stage (≤stage II) as assessed before ATR by 18F-alfatide II PET/CT represents a favorable subgroup with increased PFS and OS.

scholarly journals Clinicopathological Features and Survival of Adolescent and Young Adults with Cervical Cancer

2021 ◽  
Vol 28 ◽  
pp. 107327482110515
Author(s):  
Shuya Pan ◽  
Wenxiao Jiang ◽  
Shangdan Xie ◽  
Haiyan Zhu ◽  
Xueqiong Zhu
Keyword(s):  
Cervical Cancer ◽  
Young Adults ◽  
Regression Model ◽  
Cancer Patients ◽  
Cox Regression ◽  
Survival Curve ◽  
Young Patients ◽  
Figo Stage ◽  
Clinicopathological Characteristics ◽  
Treatment Modalities

Purpose To explore clinicopathological characteristics and their prognostic value among young patients with cervical cancer (who are aged ≤25 years old). Methods The Surveillance, Epidemiology, and End Results Program (SEER) database was used to extract data on cervical cancer patients. They were then stratified by age as young women (≤25 years old) and old women (26–35 years old) and analyzed for clinicopathology characteristics and treatment modalities. Prognosis was analyzed using Kaplan–Meier survival curve, as well as hazard ratios using Cox regression modeling. The nomogram was developed based on Cox hazards regression model. Results Compared to 26–35 years old women, patients aged ≤25 years tended to be white ethnicity, unmarried, had earlier stage of disease. There was also a better prognosis among younger cohort. Grade, FIGO stage, histologic subtypes, and surgical modalities influenced the survival outcomes of young patients. Among young cohorts, surgery prolonged the survival time of IA-IIA stage patients while surgical and non-surgical management presented no statistically prognostic difference among patients at IIB-IVB stage. Besides, the nomogram which constructed according to Cox hazards regression model which contained independent prognosis factors including FIGO stage, surgery type, and histologic type of tumor can robustly predict survival of young patients. Conclusion Cervical cancer patients ≤25 years old were uncommon and lived longer than the older patients. Among these young patients at IA-IIA stage, surgical treatment could be more effective at preventing death than non-surgery. The nomogram could perfectly predict the prognosis of young adults and adolescents with cervical cancer.

scholarly journals Construction on of a Ferroptosis-Related lncRNA-Based Model to Improve the Prognostic Evaluation of Gastric Cancer Patients Based on Bioinformatics

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiahui Pan ◽  
Xinyue Zhang ◽  
Xuedong Fang ◽  
Zhuoyuan Xin
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Roc Curve ◽  
Cox Regression ◽  
Risk Group ◽  
Survival Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
Gastric Cancer Patients

BackgroundGastric cancer is one of the most serious gastrointestinal malignancies with bad prognosis. Ferroptosis is an iron-dependent form of programmed cell death, which may affect the prognosis of gastric cancer patients. Long non-coding RNAs (lncRNAs) can affect the prognosis of cancer through regulating the ferroptosis process, which could be potential overall survival (OS) prediction factors for gastric cancer.MethodsFerroptosis-related lncRNA expression profiles and the clinicopathological and OS information were collected from The Cancer Genome Atlas (TCGA) and the FerrDb database. The differentially expressed ferroptosis-related lncRNAs were screened with the DESeq2 method. Through co-expression analysis and functional annotation, we then identified the associations between ferroptosis-related lncRNAs and the OS rates for gastric cancer patients. Using Cox regression analysis with the least absolute shrinkage and selection operator (LASSO) algorithm, we constructed a prognostic model based on 17 ferroptosis-related lncRNAs. We also evaluated the prognostic power of this model using Kaplan–Meier (K-M) survival curve analysis, receiver operating characteristic (ROC) curve analysis, and decision curve analysis (DCA).ResultsA ferroptosis-related “lncRNA–mRNA” co-expression network was constructed. Functional annotation revealed that the FOXO and HIF-1 signaling pathways were dysregulated, which might control the prognosis of gastric cancer patients. Then, a ferroptosis-related gastric cancer prognostic signature model including 17 lncRNAs was constructed. Based on the RiskScore calculated using this model, the patients were divided into a High-Risk group and a low-risk group. The K-M survival curve analysis revealed that the higher the RiskScore, the worse is the obtained prognosis. The ROC curve analysis showed that the area under the ROC curve (AUC) of our model is 0.751, which was better than those of other published models. The multivariate Cox regression analysis results showed that the lncRNA signature is an independent risk factor for the OS rates. Finally, using nomogram and DCA, we also observed a preferable clinical practicality potential for prognosis prediction of gastric cancer patients.ConclusionOur prognostic signature model based on 17 ferroptosis-related lncRNAs may improve the overall survival prediction in gastric cancer.

scholarly journals A nomogram based on Aspartate Aminotransferase/Alanine Aminotransferase (AST/ALT) ratio after surgery to predict the prognostic value in patients with gastric cancer

2020 ◽  
Author(s):  
Linfang Li ◽  
Shan Xing ◽  
Ning Xue ◽  
Miantao Wu ◽  
Yaqing Liang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Cox Regression ◽  
Staging System ◽  
Tnm Staging ◽  
Calibration Plot ◽  
Study Cohort ◽  
Tnm Staging System ◽  
Resectable Gastric Cancer

Abstract Background This study aimed to develop an effective nomogram for predicting overall survival (OS) in surgically treated gastric cancer. Methods We retrospectively evaluated 190 gastric cancer in this study. Cox regression analyses were performed to identify significant prognostic factors for OS in patients with resectable gastric cancer. The predictive accuracy of nomogram was assessed by calibration plot, concordance index (C-index) and decision curve, and then were compared with the traditional TNM staging system. Based on the total points (TPS) by nomogram, we further divided patients into different risk groups. Results On multivariate analysis of the 190 cohort, independent factors for survival were age, clinical stage and Aspartate Aminotransferase/Alanine Aminotransferase (SLR), which were entered into the nomogram. The calibration curve for the probability of OS showed that the nomogram-based predictions were in good agreement with actual observations. And the C-index of the established nomogram for predicting OS had a superior discrimination power compared with the TNM staging system [0.768 (95% CI: 0.725-0.810) vs 0.730 (95% CI: 0.688-0.772), p < 0.05]. Decision curve also demonstrated that the nomogram was better than TNM staging system. Based on the TPS of the nomogram, we further subdivided the study cohort into 3 groups: low risk (TPS ≤ 158), middle risk (158 < TPS ≤ 188), high risk (TPS > 188), the differences of OS rate were significant in the groups. Conclusions The established nomogram resulted in more accurate prognostic prediction for individual patient with resectable gastric cancer.

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