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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1382818

Screening High-Risk Individuals for Primary Gastric Adenocarcinoma: Evaluating Progression-free Survival Probability Score in the Presence and Absence of Rictor expression after gastrectomy

Provisionally accepted
Jian Wang Jian Wang *Sujiao Liang Sujiao Liang *Yifan Li Yifan Li *
  • Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi Province, China

The final, formatted version of the article will be published soon.

    Objective: Developing nomogram-based risk stratification model to determine 3-year and 5-year progressionfree survival (PFS) and to identify high-risk patients with gastric adenocarcinoma based on different Rictor statuses. Methods: 1366 individuals who underwent radical gastric surgery to treat gastric adenocarcinoma at Shanxi Cancer Hospital from May 2002 to December 2020 were analyzed. Cox regression analysis was employed to create the nomograms. The nomograms' performance was assessed using C-index, time receiver operating characteristic (t-ROC) curves, calibration curves, and decision curve analysis (DCA) curves in training and validation cohorts. Subsequently, patients were categorized into high-risk and low-risk groups based on the nomogram's risk scores. Results: The Rictor (-) nomogram for predicting PFS included variables such as age, number of positive lymph nodes, vascular invasion, maximum diameter of the tumor, omentum metastasis, and expression of MSH2. In the internal validation, the C-index of the Rictor (-) nomogram was 0.760 (95%CI: 0.720-0.799), which was superior to the C-index of the American Joint Committee on Cancer (AJCC) 8th edition TNM staging (0.683, 95%CI: 0.646-0.721). Similarly, the Rictor (+) nomogram for predicting PFS included variables such as gender, age, pT stage, number of positive lymph nodes, neural invasion, maximum diameter of the tumor, omentum metastasis, Clavien-Dindo classification for complications, and CGA expression. The C-index of the Rictor (+) nomogram was 0.795 (95%CI: 0.764-0.825), which outperformed the C-index of the AJCC 8th edition TNM staging (0.693, 95%CI: 0.662-0.723). The calibration curves, t-ROC curves, and decision curve analysis for both nomogram models demonstrated their excellent prediction ability. Conclusion: This study presents the first risk stratification for Rictor status in gastric adenocarcinoma. Our model identifies low-risk patients who may not require additional postoperative treatment, while high-risk patients should consider targeted therapies that specifically target Rictor-positive indicators.

    Keywords: Gastric adenocarcinoma, rictor, Progression-free survival, nomogram, risk stratification

    Received: 06 Feb 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Wang, Liang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jian Wang, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi Province, China
    Sujiao Liang, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi Province, China
    Yifan Li, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi Province, China

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