Prognostic value of modified Lauren classification in gastric cancer  

作　　者：Fei-Long Ning Nan-Nan Zhang Jun Wang Yi-Feng Jin Hong-Guang Quan Jun-Peng Pei Yan Zhao Xian-Tao Zeng Masanobu Abe Chun-Dong Zhang 

机构地区：[1]Department of General Surgery,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou 221000,Jiangsu Province,China [2]State Key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases,Xijing Hospital of Digestive Diseases,The Fourth Military Medical University,Xi’an 710000,Shannxi Province,China [3]Department of General Surgery,Jiading Hospital of Traditional Chinese Medicine,Shanghai 201800,China [4]Department of Gastrointestinal Surgery,The Fourth Affiliated Hospital of China Medical University,Shenyang 110032,Liaoning Province,China [5]Department of Stomach Surgery,Liaoning Cancer Hospital and Institute,Cancer Hospital of China Medical University,Shenyang 110042,Liaoning Province,China [6]Center for Evidence-Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei Province,China [7]Department of Evidence-Based Medicine and Clinical Epidemiology,The Second Clinical College of Wuhan University,Wuhan 430071,Hubei Province,China [8]Division for Health Service Promotion,The University of Tokyo,Tokyo 113-0033,Japan [9]Department of Gastrointestinal Surgery,Graduate School of Medicine,The University of Tokyo,Tokyo 113-0033,Japan

出　　处：《World Journal of Gastrointestinal Oncology》2021年第9期1184-1195,共12页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by The China Scholarship Council,No.201908050148.

摘　　要：BACKGROUND It remains controversial as to which pathological classification is most valuable in predicting the overall survival(OS)of patients with gastric cancer(GC).AIM To assess the prognostic performances of three pathological classifications in GC and develop a novel prognostic nomogram for individually predicting OS.METHODS Patients were identified from the Surveillance,Epidemiology,and End Results program.Univariate and multivariate analyses were performed to identify the independent prognostic factors.Model discrimination and model fitting were evaluated by receiver operating characteristic curves and Akaike information criteria.Decision curve analysis was performed to assess clinical usefulness.The independent prognostic factors identified by multivariate analysis were further applied to develop a novel prognostic nomogram.RESULTS A total of 2718 eligible GC patients were identified.The modified Lauren classification was identified as one of the independent prognostic factors for OS.It showed superior model discriminative ability and model-fitting performance over the other pathological classifications,and similar results were obtained in various patient settings.In addition,it showed superior net benefits over the Lauren classification and tumor differentiation grade in predicting 3-and 5-year OS.A novel prognostic nomogram incorporating the modified Lauren classification showed superior model discriminative ability,model-fitting performance,and net benefits over the American Joint Committee on Cancer 8th edition tumor-nodemetastasis classification.CONCLUSION The modified Lauren classification shows superior net benefits over the Lauren classification and tumor differentiation grade in predicting OS.A novel prognostic nomogram incorporating the modified Lauren classification shows good model discriminative ability,model-fitting performance,and net benefits.

关 键 词：Gastric cancer Pathological classification Prognostic model Tumor-nodemetastasis classification Survival outcome 

分 类 号：R735.2[医药卫生—肿瘤]