Construction of a nomogram prediction model for peritoneal metastasis in advanced gastric cancer
Zhu Jiao
Ren Xiaoyang
Wang Qing
Zhu Min
Gao Nan
Liu Ningning
Luo Miaosha
Abstract：Objective To develop a nomogram model for predicting peritoneal metastasis in advanced gastric cancer(AGC)and evaluate its discrimination and calibration.Methods A total of 135 AGC patients with peritoneal metastasis(metastasis group)and 430 AGC patients without peritoneal metastasis(non-metastasis group)who underwent radical surgery at the First Affiliated Hospital of Xi'an Jiaotong University from June 2017 to April 2024 were enrolled.Clinical data were collect-ed,and univariate and multivariate logistic regression analyses were performed to identify risk factors for peritoneal metasta-sis.A nomogram prediction model was constructed using R software,and its discrimination and calibration were validated via receiver operating characteristic(ROC)curves and calibration curves.Results The metastasis group had significantly higher proportions of patients with T3-T4 tumor invasion,TNM stage Ⅲ,ascites,lymphovascular invasion,lymph node metastasis,thickened and abnormally enhanced mesentery or greater omentum,preoperative CA125≥35 kU/L,preopera-tive CA724≥10 kU/L,preoperative neutrophil-to-lymphocyte ratio(NLR)≥2.37,and preoperative platelet-to-lympho-cyte ratio(PLR)≥132.43 compared to the non-metastasis group(P<0.05).Multivariate logistic regression identified lym-phovascular invasion(OR=3.035,95%CI:1.938-4.752),lymph node metastasis(OR=4.066,95%CI:3.535-6.522),preoperative CA125≥35 kU/L(OR=1.883,95%CI:1.186-2.989),preoperative CA724≥10 kU/L(OR=2.058,95%CI:1.291-3.281),and preoperative PLR≥132.43(OR=2.430,95%CI:1.528-3.864)as independent risk factors for peritoneal metastasis(P<0.05).The nomogram model achieved an area under the ROC curve(AUC)of 0.783(95%CI:0.740-0.826),indicating good discrimination.The calibration curve showed close agreement between predicted and ob-served values,supported by the Hosmer-Lemeshow goodness-of-fit test(χ2=6.120,P=0.634).Decision curve analysis(DCA)demonstrated clinical value of peritoneal metastasis in advanced gastric cancer of the model at threshold probabilities of 0.02-0.96.Conclusion The nomogram model for predicting peritoneal metastasis risk in AGC exhibits robust discrimi-nation and calibration,providing a valuable tool for early clinical assessment of peritoneal metastasis risk in advanced gastric cancer.
Keywords：Gastric cancerAdvanced stagePeritoneal metastasisPrediction modelNomogramRisk factors
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 47-53 )