Development And Validation Of A Nomogram Model For Overall Survival Probability Of Stomach Signet Ring Cell Carcinoma

Objective: The purpose of this study is to establish the first survival prediction model of patients with stomach signet ring cell carcinoma(SRCC)by using the nomogram.we are hoping to assist the establishment of clinical personalized diagnosis and treatment and to improve the prognosis.Methods:We included patients diagnosed as gastric SRCC by the sixth edition of American Cancer Committee on cancer st age from 2004 to 2014 in the survey,epidemiology,and end results database.Firstly,univariate and multivariable COX analyses was performed to select the parameters significantly correlating with OS,then create a nomogram by using these variables.The performance of nomogram was validated with Harrell’s concordance index,calibration curves,receiver operating characteristic curve and decision curve analysis.Result:In this study,we brought into 1459 patients diagnosed as signet ring cell carcinoma of the stomach and randomly divided them into training cohorts(n=730)and independent validation cohorts(n =729).After analysis,age at diagnosis,Lymph nodes for surgery,TNM stage,T,N,Radiation,Tumor Size(cm),Lymph node dissection and Bone metastasis became independent variables intimately related to the prognosis and was used to construct 1-,3-and 5-year prognosis nomograms.This nomogram had a C-index of 0.753(95% CI 0.730-0.775)in the training cohort.The calibration curves indicated satisfactory agreement between nomogram prediction and actual survival,decision curve analysis indicated its clinical usefulness value.Conclusions: We established and validated the first nomogram that can provide individual prediction of overall survival for patients with stomach SRCC.It can not only cooperate other researchers to carry out some follow-up clinical research on the disease,while assist them in improving the experimental decision-making and design,but also assist patients consulting and acquiring a better understanding of the disease,what’s more,it is convenient for clinicians to provide customized and individual treatment plans for patients with gastric SRCC.