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Research
Zhen Zong
Nanchang University Second Affiliated Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective
This study analyzed the characteristics of early gastric cancer lymph node metastasis and survival prognosis after surgical resection in western population, and established a predictive model.
Methods
Patients with stage T1a and T1b gastric cancer from 2010 to 2015 were screened from the surveillance, epidemiology and final outcome databases. Patients with multiple in situ tumors, distant metastases, and incomplete data were excluded. The risk factors for lymph node metastasis in early gastric cancer were analyzed by binary logistic regression and the chi-square test. Multivariate Cox analysis and the Kaplan-Meier test were used to evaluate the prognostic factors and survival rates of patients with early gastric cancer after surgical resection. The prediction model of lymph node metastasis and survival rate of early gastric cancer was established and verified by R software.
Results
In 2294 patients, the lymph node metastasis rate was 14.5% (333/2294). Binary logistic multivariate regression analysis showed that tumor size (>2cm), tumor grade (III/IV), and stage T1b were risk factors for lymph node metastasis of early gastric cancer. Area under the curve (AUC) is 0.782.A predictive model was developed based on risk factors, and the model C index was 0.771, indicating that the model has good predictive ability. In addition, survival analysis of 2294 patients showed that the 5-year OS and CSS (75.4% and 88.7%) in patients without EGC were significantly higher than those with lymph node metastasis (64.3% and 72.8%) (P<0.05). Multivariate COX analysis showed that age, sex, race, tumor size, submucosal invasion and lymph node metastasis were independent factors influencing the prognosis of early gastric cancer. A cancer-specific survival (CSS) prediction model was constructed based on prognostic risk factors. The 3-year area under the CSS curve (AUC) was 0.706, and the 5-year area under the CSS curve (AUC) was 0.710. The prediction model is more consistent with the actual situation.
Conclusions
We established a reliable prediction model for lymph node metastasis of early gastric cancer and a prognostic model for early gastric cancer, which provided a good basis for clinical treatment decision.
Keywords
Early gastric cancer, lymph node metastasis, survival prognosis, endoscopic mucosal resection, Predictive model
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Zhen Zong
Nanchang University Second Affiliated Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 23 Nov, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective
This study analyzed the characteristics of early gastric cancer lymph node metastasis and survival prognosis after surgical resection in western population, and established a predictive model.
Methods
Patients with stage T1a and T1b gastric cancer from 2010 to 2015 were screened from the surveillance, epidemiology and final outcome databases. Patients with multiple in situ tumors, distant metastases, and incomplete data were excluded. The risk factors for lymph node metastasis in early gastric cancer were analyzed by binary logistic regression and the chi-square test. Multivariate Cox analysis and the Kaplan-Meier test were used to evaluate the prognostic factors and survival rates of patients with early gastric cancer after surgical resection. The prediction model of lymph node metastasis and survival rate of early gastric cancer was established and verified by R software.
Results
In 2294 patients, the lymph node metastasis rate was 14.5% (333/2294). Binary logistic multivariate regression analysis showed that tumor size (>2cm), tumor grade (III/IV), and stage T1b were risk factors for lymph node metastasis of early gastric cancer. Area under the curve (AUC) is 0.782.A predictive model was developed based on risk factors, and the model C index was 0.771, indicating that the model has good predictive ability. In addition, survival analysis of 2294 patients showed that the 5-year OS and CSS (75.4% and 88.7%) in patients without EGC were significantly higher than those with lymph node metastasis (64.3% and 72.8%) (P<0.05). Multivariate COX analysis showed that age, sex, race, tumor size, submucosal invasion and lymph node metastasis were independent factors influencing the prognosis of early gastric cancer. A cancer-specific survival (CSS) prediction model was constructed based on prognostic risk factors. The 3-year area under the CSS curve (AUC) was 0.706, and the 5-year area under the CSS curve (AUC) was 0.710. The prediction model is more consistent with the actual situation.
Conclusions
We established a reliable prediction model for lymph node metastasis of early gastric cancer and a prognostic model for early gastric cancer, which provided a good basis for clinical treatment decision.
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