Wang D, Shi XL, Xu W, Shi RH. Nomogram model predicting the overall survival for patients with primary gastric mucosa-associated lymphoid tissue lymphoma. World J Gastrointest Oncol 2023; 15(3): 533-545 [PMID: 37009322 DOI: 10.4251/wjgo.v15.i3.533]
Corresponding Author of This Article
Rui-Hua Shi, PhD, Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, No. 87 Hunan Road, Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. ruihuashi@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2023; 15(3): 533-545 Published online Mar 15, 2023. doi: 10.4251/wjgo.v15.i3.533
Nomogram model predicting the overall survival for patients with primary gastric mucosa-associated lymphoid tissue lymphoma
Dan Wang, Xin-Lin Shi, Wei Xu, Rui-Hua Shi
Dan Wang, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
Dan Wang, Wei Xu, Rui-Hua Shi, Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, Nanjing 210009, Jiangsu Province, China
Dan Wang, Wei Xu, Rui-Hua Shi, Laboratory of Gastroenterology, Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China
Xin-Lin Shi, Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Author contributions: Shi RH contributed to conceptualization and supervision; Wang D contributed to conceptualization, data curation, formal analysis, and writing-original draft preparation; Shi XL contributed to data curation and formal analysis; Xu W contributed to supervision and editing; all authors approved the manuscript.
Institutional review board statement: The study was reviewed and approved by the Zhongda Hospital, Affiliated Hospital of Southeast University, all our data comes from public database (SEER database) and need no ethical approval.
Informed consent statement: The informed consent was waived because all of data were downloaded from open database “SEER Database”.
Conflict-of-interest statement: All authors of this paper have no conflict of interests to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui-Hua Shi, PhD, Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, No. 87 Hunan Road, Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. ruihuashi@126.com
Received: November 13, 2022 Peer-review started: November 13, 2022 First decision: January 11, 2023 Revised: February 9, 2023 Accepted: February 22, 2023 Article in press: February 22, 2023 Published online: March 15, 2023
Abstract
BACKGROUND
Increasingly extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue, known as mucosa-associated lymphoid tissue (MALT) lymphoma, is a type of non-Hodgkin’s lymphoma. The prognosis of primary gastric MALT (GML) patients can be affected by many factors. Clinical risk factors, including age, type of therapy, sex, stage and family hematologic malignancy history, also have significant effects on the development of the disease. The available data are mainly focused on epidemiology; in contrast, few studies have investigated the prognostic variables for overall survival (OS) in patients with primary GML. Based on the realities above, we searched a large amount of data on patients diagnosed with primary GML in the Surveillance, Epidemiology and End Results (SEER) database. The aim was to develop and verify a survival nomogram model that can predict the overall survival prognosis of primary GML by combining prognostic and determinant variables.
AIM
To create an effective survival nomogram for patients with primary gastric GML.
METHODS
All data of patients with primary GML from 2004 to 2015 were collected from the SEER database. The primary endpoint was OS. Based on the LASSO and COX regression, we created and further verified the accuracy and effectiveness of the survival nomogram model by the concordance index (C-index), calibration curve and time-dependent receiver operating characteristic (td-ROC) curves.
RESULTS
A total of 2604 patients diagnosed with primary GML were selected for this study. A total of 1823 and 781 people were randomly distributed into the training and testing sets at a ratio of 7:3. The median follow-up of all patients was 71 mo, and the 3- and 5-year OS rates were 87.2% and 79.8%, respectively. Age, sex, race, Ann Arbor stage and radiation were independent risk factors for OS of primary GML (all P < 0.05). The C-index values of the nomogram were 0.751 (95%CI: 0.729-0.773) and 0.718 (95%CI: 0.680-0.757) in the training and testing cohorts, respectively, showing the good discrimination ability of the nomogram model. Td-ROC curves and calibration plots also indicated satisfactory predictive power and good agreement of the model. Overall, the nomogram shows favorable performance in discriminating and predicting the OS of patients with primary GML.
CONCLUSION
A nomogram was developed and validated to have good survival predictive performance based on five clinical independent risk factors for OS for patients with primary GML. Nomograms are a low-cost and convenient clinical tool in assessing individualized prognosis and treatment for patients with primary GML.
Core Tip: Increasingly extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue, known as mucosa-associated lymphoid tissue (MALT) lymphoma, is a type of non-Hodgkin’s lymphoma. The prognosis of primary gastric MALT (GML) patients can be affected by many factors. The available data are mainly focused on epidemiology; in contrast, few studies have investigated the prognostic variables for overall survival (OS) in patients with primary GML. Based on the realities above, we searched a large amount of data on patients diagnosed with primary GML in the Surveillance, Epidemiology and End Results database. The aim was to develop and verify a survival nomogram model that can predict the OS prognosis of primary GML by combining prognostic and determinant variables. In this manuscript, our results demonstrated that Nomogram is developed and validated to have a good survival predictive performance, basing on five clinical independent risk factors of OS for primary GML patients. Nomogram will be a low cost and convenient clinical tool in assessing individualized prognosis and treatment for primary GML patients.
