Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age

Abstract Background Gastric gastrointestinal stromal tumor (GIST) is the most common sarcoma of the digestive tract. Due to the fact that younger patients often present with more aggressive disease and exhibit different treatment responses compared to older patients, this study aimed to develop mode...

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Main Authors: Yifan Cheng, Shuyang Gao, Zhen Tian, Shuai Zhao, Ruiqi Li, Jiajie Zhou, Yayan Fu, Qiannan Sun, Daorong Wang
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-03092-z
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author Yifan Cheng
Shuyang Gao
Zhen Tian
Shuai Zhao
Ruiqi Li
Jiajie Zhou
Yayan Fu
Qiannan Sun
Daorong Wang
author_facet Yifan Cheng
Shuyang Gao
Zhen Tian
Shuai Zhao
Ruiqi Li
Jiajie Zhou
Yayan Fu
Qiannan Sun
Daorong Wang
author_sort Yifan Cheng
collection DOAJ
description Abstract Background Gastric gastrointestinal stromal tumor (GIST) is the most common sarcoma of the digestive tract. Due to the fact that younger patients often present with more aggressive disease and exhibit different treatment responses compared to older patients, this study aimed to develop models to predict overall survival (OS) and cancer-specific survival (CSS) in postoperative gastric GIST patients under the age of 65, thereby aiding in the creation of optimal, individualized treatment strategies. Methods We first reviewed demographic and clinicopathological characteristics data from 1990 to 2021 of patients diagnosed with GIST in the Surveillance, Epidemiology, and End Results (SEER) database. Subsequently, we examined the data of the external validation cohort from Northern Jiangsu People’s Hospital. Utilizing Lasso analysis and multivariate Cox regression analyses, we confirmed the independent risk factors and created nomograms for the prediction of OS and CSS of postoperative gastric GIST patients under age 65, followed by validation with the external validation cohort. To assess the predictive ability of these nomograms, we employed the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC), and decision curve analysis (DCA). Results A total of 735 eligible gastric GIST patients from SEER were enrolled in the training cohort and 113 patients from Northern Jiangsu People’s Hospital were enrolled in the validation cohort. 3 factors (grade, M stage, mitotic index) associated with OS and 4 factors (grade, T stage, M stage, mitotic index) associated with CSS were included in the model respectively. In the training cohort, the C-index was 0.706 (95% CI = 0.645–0.767) for OS and 0.880 (95% CI = 0.845–0.915) for CSS, while in the validation cohort, the C-index was 0.718 (95% CI = 0.618–0.818) for OS and 0.805 (95% CI = 0.715–0.895) for CSS. Calibration curves and ROCs for 3-, 5-, and 8-year OS and CSS showed high discrimination and calibration. DCA results showed that the nomograms had clinical value in predicting OS and CSS in gastric GIST patients. Conclusion Our nomograms satisfactorily predicted OS and CSS in postoperative gastric GIST patients under age 65, which could assist clinicians in evaluating postoperative status, guiding subsequent treatments, and improving patient prognosis.
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spelling doaj-art-489d4e37f8424efe80d71a7b8fe3e9382025-08-20T03:05:05ZengSpringerDiscover Oncology2730-60112025-07-0116111310.1007/s12672-025-03092-zDevelopment and validation of a prognostic nomogram for gastric GIST patients under 65 years of ageYifan Cheng0Shuyang Gao1Zhen Tian2Shuai Zhao3Ruiqi Li4Jiajie Zhou5Yayan Fu6Qiannan Sun7Daorong Wang8Northern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityNorthern Jiangsu People’s Hospital Affiliated to Dalian Medical UniversityNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityNorthern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityNorthern Jiangsu People’s HospitalNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing UniversityAbstract Background Gastric gastrointestinal stromal tumor (GIST) is the most common sarcoma of the digestive tract. Due to the fact that younger patients often present with more aggressive disease and exhibit different treatment responses compared to older patients, this study aimed to develop models to predict overall survival (OS) and cancer-specific survival (CSS) in postoperative gastric GIST patients under the age of 65, thereby aiding in the creation of optimal, individualized treatment strategies. Methods We first reviewed demographic and clinicopathological characteristics data from 1990 to 2021 of patients diagnosed with GIST in the Surveillance, Epidemiology, and End Results (SEER) database. Subsequently, we examined the data of the external validation cohort from Northern Jiangsu People’s Hospital. Utilizing Lasso analysis and multivariate Cox regression analyses, we confirmed the independent risk factors and created nomograms for the prediction of OS and CSS of postoperative gastric GIST patients under age 65, followed by validation with the external validation cohort. To assess the predictive ability of these nomograms, we employed the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC), and decision curve analysis (DCA). Results A total of 735 eligible gastric GIST patients from SEER were enrolled in the training cohort and 113 patients from Northern Jiangsu People’s Hospital were enrolled in the validation cohort. 3 factors (grade, M stage, mitotic index) associated with OS and 4 factors (grade, T stage, M stage, mitotic index) associated with CSS were included in the model respectively. In the training cohort, the C-index was 0.706 (95% CI = 0.645–0.767) for OS and 0.880 (95% CI = 0.845–0.915) for CSS, while in the validation cohort, the C-index was 0.718 (95% CI = 0.618–0.818) for OS and 0.805 (95% CI = 0.715–0.895) for CSS. Calibration curves and ROCs for 3-, 5-, and 8-year OS and CSS showed high discrimination and calibration. DCA results showed that the nomograms had clinical value in predicting OS and CSS in gastric GIST patients. Conclusion Our nomograms satisfactorily predicted OS and CSS in postoperative gastric GIST patients under age 65, which could assist clinicians in evaluating postoperative status, guiding subsequent treatments, and improving patient prognosis.https://doi.org/10.1007/s12672-025-03092-zGastrointestinal stromal tumorNomogramOverall survivalCancer-specific survival
spellingShingle Yifan Cheng
Shuyang Gao
Zhen Tian
Shuai Zhao
Ruiqi Li
Jiajie Zhou
Yayan Fu
Qiannan Sun
Daorong Wang
Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
Discover Oncology
Gastrointestinal stromal tumor
Nomogram
Overall survival
Cancer-specific survival
title Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
title_full Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
title_fullStr Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
title_full_unstemmed Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
title_short Development and validation of a prognostic nomogram for gastric GIST patients under 65 years of age
title_sort development and validation of a prognostic nomogram for gastric gist patients under 65 years of age
topic Gastrointestinal stromal tumor
Nomogram
Overall survival
Cancer-specific survival
url https://doi.org/10.1007/s12672-025-03092-z
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