Prognostic and Predictive Model of the Log Odds of the Negative Lymph Node/T Stage Ratio in Resectable Gastric Adenocarcinoma Patients.

PURPOSE: There are few reports on disease-specific survival (DSS) prediction systems for resected gastric cancer (GC) patients. The aim of this study was to create a nomogram based on the log odds of the negative lymph node/T stage ratio (LONT) for individual risk prediction. METHODS: We applied the Surveillance, Epidemiology, and End Results (SEER) Program database released in 2021 to screen GC patients from 2010 to 2015. Using a competitive risk model, we plotted the cumulative risk curve of variables for gastric cancer-specific death and death from other causes at each time point. According to the minimum BIC, we constructed and assessed a nomogram for the 12-month, 36-month, and 60-month cumulative mortality probabilities assessed by time-dependent ROC curves (time-AUCs), the C-index, Brier scores, decision curve analysis (DCA), and calibration curves. RESULTS: A total of 3895 patients were ultimately included and randomly assigned to two sets: the training set (n = 2726, 70%) and the validation set (n = 1169, 30%). The LONT was a remarkable independent predictor of gastric cancer-specific death (high versus low: 0.705, 95% CI 0.524-0.95, p = 0.021). The variables selected based on the minimum BIC were as follows: location, AJCC, AJCC.T, AJCC.N, radiotherapy, LONT.cat, and chemotherapy. According to the time-AUC, C-index, Brier score, DCA, and calibration curves, the nomogram risk score had excellent survival prediction ability for DSS. CONCLUSIONS: A low LONT was associated with a high cumulative incidence of DSS. A prognostic nomogram model based on the LONT could effectively predict DSS for resectable GC patients.

Corrigendum: LncRNA MSC-AS1 Is a Diagnostic Biomarker and Predicts Poor Prognosis in Patients With Gastric Cancer by Integrated Bioinformatics Analysis.

[This corrects the article DOI: 10.3389/fmed.2021.795427.].

LncRNA MSC-AS1 Is a Diagnostic Biomarker and Predicts Poor Prognosis in Patients With Gastric Cancer by Integrated Bioinformatics Analysis.

Numerous studies have shown that long uncoded RNA (lncRNA) MSC-AS1 may play an important role in the occurrence and development of some types of cancer. However, its role in gastric cancer has rarely been discussed. This study aimed to clarify the association between lncRNA MSC-AS1 and gastric cancer using The Cancer Genome Atlas (TCGA) database. We determined the expression of MSC-AS1 using the Wilcoxon rank sum test; in addition, logistic regression was applied to evaluate the association between MSC-AS1 and clinicopathological characteristics. Also, Kaplan-Meier and Cox regression were used to evaluate the relationship between MSC-AS1 and survival. A nomogram was conducted to predict the impact of MSC-AS1 on prognosis. Moreover, Gene Set enrichment analysis (GSEA) was performed to annotate the biological function of MSC-AS1. Quantitative analysis of immune infiltration was carried out by single-set GSEA (ssGSEA). The MSC-AS1 level was elevated in gastric cancer tissues. An increased MSC-AS1 level was significantly correlated with T stage (odds ratio [OR] = 2.55 for T3 and T4 vs. T1 and T2), histological type (OR = 5.28 for diffuse type vs. tubular type), histological grade (OR = 3.09 for grade 3 vs. grades 1 and 2), TP53 status (OR = 0.55 for mutated vs. wild type), and PIK3CA status (OR = 0.55 for mutated vs. wild type) (all p < 0.05) by univariate logistic regression. Kaplan-Meier survival analysis showed high MSC-AS1 expression had a poor overall survival [hazard ratio (HR) = 1.75; 95% confidence interval (CI): 1.25-2.45; p = 0.001] and progression-free interval (HR = 1.47; 95% CI: 1.03-2.10; p = 0.034). Multivariate survival analysis revealed that MSC-AS1 expression (HR = 1.681; 95% CI: 1.057-2.673; p = 0.028) was independently correlated with overall survival. GSEA demonstrated that the P38/MAPK pathway, the VEGF pathway, the cell adhesion molecules cams, the NOD-like receptor signaling pathway were differentially enriched in the high MSC-AS1 expression phenotype. SsGSEA and Spearman correlation revealed the relationships between MSC-AS1 and macrophages, NK cells, and Tems were the strongest. Coregulatory proteins were included in the PPI network. Upregulated lncRNA MSC-AS1 might be a potential biomarker for the diagnosis and prognosis of gastric cancer.

Various Kinds of Functional Digestive Tract Reconstruction Methods After Proximal Gastrectomy.

The incidence of proximal gastric cancer has shown a rising trend in recent years. Surgery is still the main way to cure proximal gastric cancer. Total gastrectomy with D2 lymph node dissection was considered to be the standard procedure for proximal gastric cancer in the past several decades. However, in recent years, many studies have confirmed that proximal gastrectomy can preserve part of the stomach function and can result in a better quality of life of the patient than total gastrectomy. Therefore, proximal gastrectomy is increasingly used in patients with proximal gastric cancer. Unfortunately, there are some concerns after proximal gastrectomy with traditional esophagogastrostomy. For example, the incidence of reflux esophagitis in patients who underwent proximal gastrectomy with traditional esophagogastrostomy is significantly higher than those patients who underwent total gastrectomy. To solve those problems, various functional digestive tract reconstruction methods after proximal gastrectomy have been proposed gradually. In order to provide some help for clinical treatment, in this article, we reviewed relevant literature and new clinical developments to compare various kinds of functional digestive tract reconstruction methods after proximal gastrectomy mainly from perioperative outcomes, postoperative quality of life and survival outcomes aspects. After comparison and discussion, we drew the conclusion that various functional reconstruction methods have their own advantages and disadvantages; large scale high-level clinical studies are needed to choose an ideal reconstruction method in the future. Besides, in clinical practice, surgeons should consider the condition of the patient for individualized selection of the most appropriate reconstruction method.