Development and Validation of a Nomogram Predicting The Overall Survival for Patients With Primary Gastric Mucosa‐Associated Lymphoid Tissue Lymphoma: A SEER-Based Study

Abstract

Purpose: To create an effective survival nomogram for patients with primary gastric mucosa‐associated lymphoid tissue (MALT) lymphoma (GML).Methods. All data of patients with primary GML from 2004 to 2015 were collected from the Surveillance, Epidemiology and End Results (SEER) database. The primary endpoint was overall survival (OS). Based on the LASSO and COX regression, we created and further verified the accuracy and effectiveness of the survival nomogram model by the concordance index (C-index), calibration curve and time-dependent receiver operating characteristic (td-ROC) curves.Results. A total of 2604 patients diagnosed with primary GML were selected for this study. A total of 1823 and 781 people were randomly distributed into the training and testing sets at a ratio of 7:3. The median follow-up of all patients was 71 months, and the 3- and 5-year OS rates were 87.2% and 79.8%, respectively. Age, sex, race, Ann Arbor stage and radiation were independent risk factors for OS of primary GML (all p<0.05). The C-index values of the nomogram were 0.751 (95% CI: 0.729-0.773) and 0.718 (95% CI: 0.680-0.757) in the training and testing cohorts, respectively, showing the good discrimination ability of the nomogram model. Td-ROC curves and calibration plots also indicated satisfactory predictive power and good agreement of the model. Overall, the nomogram shows favorable performance in discriminating and predicting the OS of patients with primary GML.Conclusions. A nomogram was developed and validated to have good survival predictive performance based on five clinical independent risk factors for OS for patients with primary GML. Nomograms are a low-cost and convenient clinical tool in assessing individualized prognosis and treatment for patients with primary GML.