Nomogram models for predicting lymph node metastasis and prognosis in early gastric cancer 60 or older: a population-based cohort study.

Background: Lymph node metastasis (LNM) is a critical determinant significantly impacting the prognosis of early gastric cancer (EGC).

Methods: In this study, we included 1516 elderly EGC from the Surveillance, Epidemiology, and End Results (SEER) database and 130 patients from China to identify the independent risk factors influencing LNM, overall survival (OS) and cancer-specific survival (CSS) among elderly EGC (60 or older), respectively.

Results: Within the SEER database, the training cohort revealed that four variables (tumor size, grade, T stage, and examined lymph node count (ELNC)), six variables (age, sex, tumor size, T stage, N stage, and ELNC), and six variables (age, sex, tumor size, tumor location, T stage, and N stage) were identified as essential components in the development of nomograms for LNM, OS, and CSS prediction, respectively. Then, the receiver operating characteristic curve, calibration curve, and decision curve analysis consistently demonstrated the robust predictive capability of these nomograms. Moreover, the application of postoperative adjuvant chemotherapy exhibited a significant positive impact on the survival prognosis of stage Ib patients.

Conclusions: These nomograms for predicting both LNM and survival not only contributed to a deeper comprehension of the underlying biological traits of EGC but also offered a scientific framework to guide treatment decisions.