1. Introduction
Gastric cancer, tumor, cancer, deaths, AJCC, gastric cancer
GASTRIC CANCER, TUMOR, METASTASIS, LUNG METASTASIS, CANCER, BRAIN METASTASES, BONE METASTASIS, REGRESSIONS, REGRESSION, METASTATIC GASTRIC ADENOCARCINOMA, LIVER METASTASIS, GASTRIC CANCER
The aim of this study was to investigate the prognostic factors affecting overall survival in patients with metastatic gastric adenocarcinoma and to establish a nomogram prediction model for comprehensive clinical application. Data from 2370 patients with metastatic gastric adenocarcinoma between 2010 and 2017 were retrieved from the surveillance, epidemiology, and end results database. They were randomly divided into a training set (70%) and a validation set (30%), univariate and multivariate Cox proportional hazards regressions were used to screen important variables that may affect overall survival and to establish the nomogram. The nomogram model was evaluated using a receiver operating characteristic curve, calibration plot, and decision curve analysis. Internal validation was performed to test the accuracy and validity of the nomogram. Univariate and multivariate Cox regression analyses revealed that, age, primary site, grade, and American joint committee on cancer. T, bone metastasis, liver metastasis, lung metastasis, tumor Size, and chemotherapy were identified as independent prognostic factors for overall survival and were included in the prognostic model to construct a nomogram. The prognostic nomogram showed good overall survival risk stratification ability for the area under the curve, calibration plots, and decision curve analysis in both the training and validation sets. Kaplan–Meier curves further showed that patients in the low-risk group had better overall survival. This study synthesizes the clinical, pathological, therapeutic characteristics of patients with metastatic gastric adenocarcinoma, establishes a clinically effective prognostic model, and that can help clinicians to better evaluate the patient’s condition and provide accurate treatment.Gastric cancer remains an important cancer worldwide, and according to global cancer statistics in 2020, there have been more than 1 million new cases of gastric cancer and nearly 769,000 deaths. Gastric cancer has become the cancer with the fifth incidence and fourth mortality. Among these, East Asia had the highest incidence of gastric cancer.Although gastric cancer screening has become more common in recent years with advances in endoscopic screening techniques and increased risk awareness, most patients still present with distant metastasis. Among them, 16.92%, 5.92%, 5.08%, and 0.79% developed liver, lung, bone and brain metastases, respectively.Currently, the prognosis of gastric cancer is based on the TNM stage system issued by the union for international cancer control and the American joint committee on cancer (AJCC).