Prediction Model for Advanced Gastric Cancer in Elderly

Data were collected from 1436 gastric cancer patients, of which 555 elderly patients with advanced gastric cancer were ultimately included after applying exclusion criteria. Patients were divided into training and testing cohorts from the Fujian Medical University Affiliated Union Hospital and Dalian University Affiliated Zhongshan Hospital. The study was approved by the institutional review boards with a waiver of informed consent due to the use of anonymized secondary data. The analysis utilized the Cox proportional hazards model to select key variables for predicting overall survival (OS). The study also implemented rigorous data handling procedures, including multiple imputations for missing data. The development of an online prognostic tool based on the Nomogram model is part of the project, designed to provide real-time survival predictions through a user-friendly interface for clinical application.

Inclusion criteria

• Confirmed as primary gastric adenocarcinoma by preoperative gastric endoscopy pathology;
• Underwent R0 laparoscopic radical gastrectomy for gastric cancer;
• Pathological stage T2-4a-N+;
• Age ≥ 65 years.

Exclusion criteria

• Pathological stage T1 and T2N0;
• Age < 65 years;
• Presence of peritoneal or distant metastasis confirmed before or during surgery;
• Received neoadjuvant chemotherapy before surgery;
• Remnant gastric cancer;
• Emergency surgery or palliative exploratory surgery;
• Preoperative abdominal CT scan not available or preoperative examination time > 1 month;
• Survival time less than 1 month;
• Incomplete clinical and pathological data.