A validated survival nomogram for early-onset diffuse gastric cancer

Area of Science:

• Oncology
• Medical Statistics

Background:

• Early-onset diffuse gastric cancer (EODGC) presents unique challenges in risk stratification.
• Existing staging systems may not fully capture individual prognostic variability.

Purpose of the Study:

• To develop and validate a prognostic nomogram for personalized survival prediction in EODGC patients.
• To compare the nomogram's performance against the established AJCC staging system.

Main Methods:

• Retrospective analysis of 794 EODGC patients from the SEER database (training and internal validation sets).
• Independent validation using data from 82 EODGC patients at Renmin Hospital of Wuhan University.
• LASSO regression to identify key clinicopathological predictors for nomogram construction.

Main Results:

• Five features (race, AJCC stage, primary site surgery, chemotherapy, tumor size) were identified for the nomogram.
• The developed nomogram demonstrated superior predictive performance and calibration compared to the AJCC staging system.
• The nomogram showed good accuracy in both SEER and independent validation cohorts.

Conclusions:

• A novel survival nomogram provides accurate and individualized prognostic predictions for EODGC patients.
• The nomogram may serve as a valuable tool for clinical decision-making, outperforming the current AJCC staging.
• Further validation in diverse populations is warranted to solidify its clinical utility.