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Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Development of the Novel G-CMAP Score: A Preoperative Scoring System for Predicting Postoperative Complications After
Keisuke Okuno1, Masanori Tokunaga2, Kei Ishihara2
1Department of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan. okuno.srg1@tmd.ac.jp.
Background:
Postoperative complications after gastrectomy for gastric cancer (GC) increase mortality and delay recovery. Simple, objective tools for preoperative risk stratification using routine data remain limited. This study aimed to develop a clinically practical risk score to predict postoperative complications from standard preoperative laboratory tests.
Methods:
The study analyzed the data of 490 patients who underwent curative gastrectomy for GC between January 2017 and September 2025. Preoperative hematologic and biochemical parameters were systematically screened to predict postoperative complications of Clavien-Dindo grade II or higher. A composite predictive scoring system was developed, and model performance was assessed using multivariate logistic regression analysis and bootstrap internal validation.
Results:
Postoperative complications of Clavien-Dindo grade II or higher occurred for 89 patients (18%). Based on discriminative performance, the C-reactive protein level, monocyte count, serum albumin level, and prothrombin time-international normalized ratio were identified as independent predictors of postoperative complications. An 8-point scoring system, termed the G-CMAP score, was constructed using odds ratio-based weighting. The G-CMAP score demonstrated modest predictive ability (area under the curve, 0.68) and remained an independent predictor in multivariate analysis (odds ratio, 3.42; 95% confidence interval, 2.08-5.61; P < 0.001). Finally, bootstrap internal validation confirmed good discrimination and calibration, with minimal overfitting.
Conclusions:
The G-CMAP score is a simple and objective blood-based tool that enables modest preoperative prediction of postoperative complications after gastrectomy for GC.
