4. Discussion
tumor, Tumor, cancer, Adenocarcinoma, heterogeneous disease
TUMOR, METASTASIS, TUMOR, LIVER METASTASIS, CANCER, ADENOCARCINOMA, PRIMARY TUMOR, METASTATIC GASTRIC ADENOCARCINOMA, METASTASES, GASTRIC CANCER
Adenocarcinoma remains the most common pathological type of gastric malignancy, and metastatic gastric adenocarcinoma remains a serious threat to human health as a heterogeneous disease.As a visualization of multivariate prognostic models, nomograms integrate multiple prognostic factors and can be used to accurately assess the probability of survival of patients at a specific time and to predict the long-term survival of cancer patients.Previous studies have shown that age is a risk factor affecting the prognosis of gastric cancer, the risk ratio of elderly patients is significantly increased, and the survival time is significantly shortened compared with young patients.The primary tumor site has been shown to be one of the factors affecting the survival outcome of patients.Tumor size is another factor that has been shown to influence the survival outcome of patients, and we usually refer to the maximum diameter of the tumor that can be measured as its size.As the tumor burden increases, the tumor develops distant metastases. Liver metastasis is the most common site of distant metastasis in gastric cancer, and the prognosis of this type of patient is poor, with a median OS of only 2 to 3 months.This study has several limitations. First, the SEER database does not contain specific information about chemotherapy, radiotherapy, etc, such as the dose of chemotherapy drugs and target volumes, which are also important for the prognosis of patients with metastatic gastric adenocarcinoma. Second, missing data could have led to selection bias. Third, we did not perform an external validation to further evaluate the nomogram. Next, this can be verified by including a large number of patients from different regions to prove that the prediction models have better applicability. Our study also had certain advantages. First, to our knowledge, this study is the first to use a nomogram model to predict overall survival in patients with metastatic gastric adenocarcinoma. Second, this study developed a nomogram based on a large population and conducted internal validation, making the model relatively reliable and helping clinicians provide individualized treatment for patients with metastatic gastric adenocarcinoma.