Analysis of prognostic factors and construction of nomogram model in patients undergoing oxaliplatin combined with capecitabine adjuvant chemotherapy after radical gastrectomy for gastric cancer
Objective To analyze the prognostic factors of patients undergoing oxaliplatin combined with capecitabi-ne adjuvant chemotherapy after radical gastrectomy for gastric cancer,and to construct a nomogram model.Method A total of 232 patients with gastric cancer underwent radical gastrectomy and D2 lymph node dissection,and were treated with oxaliplatin combined with capecitabine adjuvant chemotherapy after surgery.All patients were followed up for 3 years,the patients were divided into survival group and death group according to the survival status during follow up,and the clinical characteristics of the two groups were compared.Cox proportional hazards regression model was used to an-alyze the influencing factors for prognosis of gastric cancer patients and to construct a nomogram prediction model.Cal-ibration curve and decision curve were used to verify the prediction efficiency and reliability of the nomogram model.Result The proportion of patients with tumor size≥5 cm,total gastrectomy,TNM stage Ⅲ,neutrophil-to-lymphocyte ratio(NLR)≥4,carcinoembryonic antigen(CEA)≥6 ng/ml and prognostic nutritional index(PNI)＜45 in death group(n=85)were significantly higher than those in survival group(n=147),and the differences were statistically significant(P＜0.01).Cox regression analysis showed that tumor size≥5 cm,total gastrectomy,TNM stage Ⅲ,NLR≥4,CEA≥6 ng/ml,and PNI＜45 were risk factors for poor prognosis of gastric cancer patients(P＜0.05).The C-index of this nomogram model for predicting prognosis of patients with gastric cancer was 0.933(95％CI:0.901-0.964),and the calibration curve showed high agreement between the observed and predicted values of patient prognosis risk.The threshold of this nomo-gram model was＞0.04,and its clinical net benefit was significantly higher than the single predictor of tumor size,gastric resection method,TNM stage,NLR,CEA,and PNI.Conclusion Tumor size≥5 cm,total gastrectomy,TNM stage Ⅲ,NLR≥4,CEA≥6 ng/ml,and PNI＜45 are risk factors for poor prognosis of patients undergoing oxaliplatin combined with capecitabine adjuvant chemotherapy after radical gastrectomy for gastric cancer.The nomogram prediction model based on this has high predictive value and can provide basis for improving the prognosis of patients.
radical gastrectomy for gastric canceroxaliplatin combined with capecitabine adjuvant chemotherapynomogram model
万方数据
维普
