Retrospective analysis of risk factors for distant metastasis of early-onset gastric cancer during the perioperative period

Abstract

BackgroundAlthough the overall global incidence of gastric cancer has been declining, the number of new cases in people under the age of 50 is increasing, which is related to metastasis, late pathological stages, and poor prognosis. There is a scarcity of large-scale studies to evaluate and predict distant metastasis in patients with early-onset gastric cancer.MethodsFrom January 2010 to December 2019, data on early-onset GC patients undergoing surgery were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the independent risk factors for distant metastasis in patients with early-onset gastric cancer. Based on these risk factors, we developed a nomogram to predict distant metastasis. The model underwent internal validation on the test set and external validation on 205 patients from the First Affiliated Hospital of Sun Yat-sen University and the seventh Affiliated Hospital of Sun Yat-sen University. The novel nomogram model was then evaluated using the receiver operating characteristic (ROC) curve, calibration, the area under the curve (AUC), and decision curve analysis (DCA). The training set nomogram score was used to classify the different risk clusters of distant metastasis.ResultsOur study enrolled 2217 patients after establishing the inclusion and exclusion criteria, with 1873 having no distant metastasis and 344 having distant metastasis. The tumor size, total lymph nodes, whether or not receiving radiotherapy and chemotherapy, T stage, and N stage were significant predictors of advanced distant metastasis (p < 0.05). The AUC of the ROC analysis demonstrated our model’s high accuracy. Simultaneously, the prediction model shows high stability and clinical practicability in the calibration curve and DCA analysis.ConclusionsWe developed an innovative nomogram containing clinical and pathological characteristics to predict distant metastasis in patients younger than 50 years old with gastric cancer. The tool can alert clinicians about distant metastasis and help them develop more effective clinical treatment plans.

LncRNA THUMPD3-AS1 promotes invasion and EMT in gastric cancer by regulating the miR-1297/BCAT1 pathway

“…Convincing evidence indicates that lncRNAs play an important role in the pathogenesis of GC and have great value for GC diagnosis and treatment. 8 , 27 , 28 , 29 These abnormal lncRNAs are involved in various behaviors of GC cells, including proliferation, apoptosis, metastasis, drug resistance, etc. In this study, our main objective was to identify and validate an important lncRNA THUMPD3-AS1 and investigate its regulatory mechanisms for gastric cancer cell invasion and EMT in the context of gastric cancer by using clinical tissue samples and extensive biological analysis.…”

Distinct characteristics of distant metastasis in early-onset gastric cancer patients compared to late-onset patients: An observational study

“…The most common sites of metastasis include the liver, distant lymph nodes, and peritoneum. [ 7 ] The liver stands out as the primary site of distant metastases, affecting approximately 50% of GC patients. Despite this, the relationship between age and distant metastasis has yet to be fully elucidated.…”