Development and validation of a Surveillance, Epidemiology, and End Results (SEER)-based prognostic nomogram for predicting survival in gastric cancer with multi-organ metastases

BackgroundNomogram can be used to accurately predict the prognosis of patients and guide treatment according to the individual situation of patients. This study is to investigate the independent prognostic factors for multi-organ metastases in gastric cancer (GC) patients, and construct and validate prognostic nomograms for overall survival (OS) and cancer-specific survival (CSS). MethodsThe clinical data of GC patients with multi-organ metastases from 2010 to 2018 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The independent prognostic factors affecting the OS and CSS of the patients were screened using univariate and multivariate Cox's proportional hazards model and the Fine-Gray competing risk model. Corresponding nomogram models were constructed to predict the OS and CSS of the patients. The reliability and accuracy of the prediction model were evaluated by consistency index (C-index), area under receiver operating characteristic (ROC) curve (AUC) and calibration curve. ResultsA total of 1,386 patients were included and randomly divided into a training group (972 cases) and a validation group (414 cases) in a 7:3 ratio. Cox proportional hazards analysis showed that age [P