Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study
BackgroundThe incidence of early onset gastric cancer(EOGC) is increasing. However, few studies have focused on early onset early stage gastric cancer(EEGC). The aim of this study was to determine the threshold age of patients with EOGC, identify the clinicopathological characteristics associated wi...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1544758/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850171831854563328 |
|---|---|
| author | Binghe Zhao Binghe Zhao Mingyu Gu Zijian Wang Jie Li Jie Li Minghai Wen Minghai Wen Di Wu Shuo Li Shuo Li Lu Liu Lu Liu Xinxin Wang Xinxin Wang |
| author_facet | Binghe Zhao Binghe Zhao Mingyu Gu Zijian Wang Jie Li Jie Li Minghai Wen Minghai Wen Di Wu Shuo Li Shuo Li Lu Liu Lu Liu Xinxin Wang Xinxin Wang |
| author_sort | Binghe Zhao |
| collection | DOAJ |
| description | BackgroundThe incidence of early onset gastric cancer(EOGC) is increasing. However, few studies have focused on early onset early stage gastric cancer(EEGC). The aim of this study was to determine the threshold age of patients with EOGC, identify the clinicopathological characteristics associated with lymph node metastasis(LNM) in EEGC, and develop a predictive model for LNM in EEGC.MethodsA retrospective cohort study was conducted, including 1765 patients with early-stage gastric cancer. Logistic inflection point and stratified analysis were used to determine the threshold age. 266 patients met the criteria for EEGC and were included for further analysis. The patients were divided into two groups for the purposes of the study: a training dataset and an external validation dataset. The division of patients into these two groups was conducted in accordance with the time of surgery, with the ratio of patients in each group being approximately 7:3.Univariate and multivariate logistic regression analysis were used to identify LNM risk factors. A predictive nomogram was developed and validated using calibration plots and the area under the curve (AUC).The constructed logistic regression model was then validated using the external validation dataset.ResultsThe threshold age for EOGC was determined to be 45 years. Of the 266 patients with EEGC, 20.7% had LNM. Tumor maximum diameter and lymphovascular invasion were identified as independent risk factors for LNM. The nomogram demonstrated high predictive accuracy, with an AUC of 0.809.ConclusionsThis study demonstrated that tumor maximum diameter and lymphovascular invasion were independent risk factors for LNM in EEGC. The predictive nomogram showed promising accuracy and might assist in identifying patients at higher risk of LNM, potentially informing treatment strategies. Given the relatively high LNM rate, endoscopic submucosal dissection may not be suitable for EEGC patients. Further large-scale multicenter studies are needed to deepen the understanding of this population and to confirm these findings. |
| format | Article |
| id | doaj-art-e5f25daa84b14a7da6d473f1571c34f7 |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-e5f25daa84b14a7da6d473f1571c34f72025-08-20T02:20:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15447581544758Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort studyBinghe Zhao0Binghe Zhao1Mingyu Gu2Zijian Wang3Jie Li4Jie Li5Minghai Wen6Minghai Wen7Di Wu8Shuo Li9Shuo Li10Lu Liu11Lu Liu12Xinxin Wang13Xinxin Wang14Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaDepartment of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical College, Nankai University, Tianjin, ChinaBackgroundThe incidence of early onset gastric cancer(EOGC) is increasing. However, few studies have focused on early onset early stage gastric cancer(EEGC). The aim of this study was to determine the threshold age of patients with EOGC, identify the clinicopathological characteristics associated with lymph node metastasis(LNM) in EEGC, and develop a predictive model for LNM in EEGC.MethodsA retrospective cohort study was conducted, including 1765 patients with early-stage gastric cancer. Logistic inflection point and stratified analysis were used to determine the threshold age. 266 patients met the criteria for EEGC and were included for further analysis. The patients were divided into two groups for the purposes of the study: a training dataset and an external validation dataset. The division of patients into these two groups was conducted in accordance with the time of surgery, with the ratio of patients in each group being approximately 7:3.Univariate and multivariate logistic regression analysis were used to identify LNM risk factors. A predictive nomogram was developed and validated using calibration plots and the area under the curve (AUC).The constructed logistic regression model was then validated using the external validation dataset.ResultsThe threshold age for EOGC was determined to be 45 years. Of the 266 patients with EEGC, 20.7% had LNM. Tumor maximum diameter and lymphovascular invasion were identified as independent risk factors for LNM. The nomogram demonstrated high predictive accuracy, with an AUC of 0.809.ConclusionsThis study demonstrated that tumor maximum diameter and lymphovascular invasion were independent risk factors for LNM in EEGC. The predictive nomogram showed promising accuracy and might assist in identifying patients at higher risk of LNM, potentially informing treatment strategies. Given the relatively high LNM rate, endoscopic submucosal dissection may not be suitable for EEGC patients. Further large-scale multicenter studies are needed to deepen the understanding of this population and to confirm these findings.https://www.frontiersin.org/articles/10.3389/fonc.2025.1544758/fullearly onset gastric cancerearly onset early stage gastric cancerlymph node metastasisnomogramendoscopic submucosal dissection |
| spellingShingle | Binghe Zhao Binghe Zhao Mingyu Gu Zijian Wang Jie Li Jie Li Minghai Wen Minghai Wen Di Wu Shuo Li Shuo Li Lu Liu Lu Liu Xinxin Wang Xinxin Wang Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study Frontiers in Oncology early onset gastric cancer early onset early stage gastric cancer lymph node metastasis nomogram endoscopic submucosal dissection |
| title | Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study |
| title_full | Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study |
| title_fullStr | Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study |
| title_full_unstemmed | Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study |
| title_short | Risk factors and nomogram development for lymph node metastasis in early-onset early-stage gastric cancer: a retrospective cohort study |
| title_sort | risk factors and nomogram development for lymph node metastasis in early onset early stage gastric cancer a retrospective cohort study |
| topic | early onset gastric cancer early onset early stage gastric cancer lymph node metastasis nomogram endoscopic submucosal dissection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1544758/full |
| work_keys_str_mv | AT binghezhao riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT binghezhao riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT mingyugu riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT zijianwang riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT jieli riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT jieli riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT minghaiwen riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT minghaiwen riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT diwu riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT shuoli riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT shuoli riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT luliu riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT luliu riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT xinxinwang riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy AT xinxinwang riskfactorsandnomogramdevelopmentforlymphnodemetastasisinearlyonsetearlystagegastriccanceraretrospectivecohortstudy |