Establishment and validation of the nomogram of prognostic risk factors in women with advanced gastric cancer

Prognostic factors play a critical role in determining the outcome of patients with gastric cancer (GC). Despite being a high-risk population for GC, there is a lack of previous studies on personalized predictive models for prognosis in women with advanced GC. This study aimed to identify factors influencing the prognosis of women with advanced GC and to utilize these factors to establish a nomogram model for individualized prognosis prediction. Clinical data from 418 female patients with advanced GC, admitted between 2011 and 2016, were included in this retrospective study. The patients were randomly divided into a training cohort (n = 313) and a validation cohort (n = 105). Univariate and multivariable Cox regression analyses were performed to identify prognostic factors associated with advanced GC in women. Based on these results, a nomogram model was constructed, and its accuracy was assessed using C-index and calibration curves of the training group and the validation group. Multivariable Cox regression analysis revealed that several factors were independent prognostic risk factors affecting women with advanced GC. These factors included T stage (P < .001, [hazard ratio (HR)] = 1.415 [1.169,1.712]), N stage (P < .001, [HR] = 1.267 [1.127,1.425]), tumor size (P < .001, [HR] = 1.377 [1.027,1.846]), tumor location (P = .012, [HR] = 0.432 [0.244,0.765]), neutrophil-to-lymphocyte ratio (P = .011, [HR] = 1.383 [1.062,1.802]), and radical surgery (P = .003, [HR] = 0.444 [0.249,0.790]). These factors were incorporated into a nomogram model, which demonstrated improved accuracy in predicting prognosis when validated using the independent validation cohort. The C-index values of the training and validation cohorts are 0.720 and 0.718 respectively. Calibration curves demonstrated satisfactory calibration in both the training and validation cohorts. Our study identified T stage, N stage, tumor size, tumor location, neutrophil-to-lymphocyte ratio, and radical surgery as independent prognostic risk factors influencing the outcomes of female patients with advanced GC. The developed nomogram model provides a visualized and accurate tool for individualized prognosis prediction in this population.