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42 PagesPosted: 15 Oct 2024
See all articles by Ze-Ning Huang
Ze-Ning Huang
Fujian Medical University - Department of Gastric Surgery
Qi-Chen He
Fujian Medical University - Department of Gastric Surgery
Yu-Qin Sun
Fujian Medical University - Department of Gastric Surgery
Yu-Bin Ma
Qinghai University - Qinghai University Medical College
Wenwu Qiu
Fujian Medical University - Department of Gastric Surgery
Ji-Xun He
affiliation not provided to SSRN
Chao-Hui Zheng
Fujian Medical University - Department of Gastric Surgery
Ping Li
Fujian Medical University - Department of Gastric Surgery
Jia-Bin Wang
Fujian Medical University - Fujian Medical University Union Hospital
QiYue Chen
Fujian Medical University - Department of Gastric Surgery
Long-Long Cao
Fujian Medical University - Department of Gastric Surgery
Mi Lin
Fujian Medical University - Fujian Medical University Union Hospital; Fujian Medical University - Department of Gastric Surgery
Ru-Hong Tu
Fujian Medical University - Fujian Medical University Union Hospital
Chang-Ming Huang
Fujian Medical University - Department of Gastric Surgery; Fujian Medical University - Key Laboratory of Ministry of Education of Gastrointestinal Cancer; Fujian Medical University - Fujian Key Laboratory of Tumor Microbiology
Jian-Xian Lin
Fujian Medical University - Department of Gastric Surgery
Jian-Wei Xie
Fujian Medical University - Department of Gastric Surgery
More...
Abstract
Background: Neoadjuvant chemotherapy (NAC) can improve the prognosis of patients with locally advanced (LAGC). However, precise models for accurately predicting prognosis are lacking.
Methods: In this study, the internal cohort was randomly divided into a training set and validation set in a 6:4 ratio. Feature variables were selected using Cox regression, and models were constructed using six machine learning algorithms. Model performance was evaluated using area under the curve (AUC) value and Brier scores.
Results: This study included 385 patients, including 167 in the internal training set, 112 in the internal validation set, and 106 in the external validation set. The support vector machine (SVM) model was identified as the best predictive model (AUC values: 0.96 for the internal training set, 0.75 for the internal validation set, and 0.70 for the external validation set), outperforming the ypTNM staging system (AUC values: 0.9636 vs. 0.7170 for the internal training set, 0.7503 vs. 0.6700 for the internal validation set, and 0.7036 vs. 0.6960 for the external validation set). In the internal cohort, patients in the HRG had significantly lower mean OS than that of patients in the LRG (47.90 vs. 65.72 months, log-rank P = 0.001). Patients in the HRG also had a higher recurrence rate than that of patients in the LRG (35.1% vs. 48.6%, P = 0.026).
Conclusions: The SVM model predicted postoperative survival and recurrence patterns in patients with gastric cancer after NAC and potentially outperformed the traditional ypTNM staging system.
Funding:This study was supported by Province Medical “Creating high-level hospitals, high-level medical centers and key specialty projects” [MWYZ (2021) No. 76].
Declaration of Interest:There are no conflicts of interest or financial ties to disclose from any authors.
Ethical Approval:This study was approved by the Institutional Review Board of the Affiliated Union Hospital of Fujian Medical University and the Affiliated Zhangzhou Hospital of Fujian Medical University, and the Affiliated Hospital of Qinghai University. Written informed consent was obtained from all patients.
Keywords: Machine learning, Neoadjuvant chemotherapy, Gastric cancer, Gastrectomy
Suggested Citation:Suggested Citation
Huang, Ze-Ning and He, Qi-Chen and Sun, Yu-Qin and Ma, Yu-Bin and Qiu, Wenwu and He, Ji-Xun and Zheng, Chao-Hui and Li, Ping and Wang, Jia-Bin and Chen, QiYue and Cao, Long-Long and Lin, Mi and Lin, Mi and Tu, Ru-Hong and Huang, Chang-Ming and Lin, Jian-Xian and Xie, Jian-Wei, Predicting the Prognosis of Radical Gastrectomy after Neoadjuvant Chemotherapy Based on Machine Learning Technology: A Multicenter Study in China Type. Available at SSRN: https://ssrn.com/abstract=4986352 or http://dx.doi.org/10.2139/ssrn.4986352
Ze-Ning Huang
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
Qi-Chen He
Fujian Medical University - Department of Gastric Surgery ( email )
Yu-Qin Sun
Fujian Medical University - Department of Gastric Surgery ( email )
Yu-Bin Ma
Qinghai University - Qinghai University Medical College ( email )
Xining, 810000
China
Wenwu Qiu
Fujian Medical University - Department of Gastric Surgery ( email )
Ji-Xun He
affiliation not provided to SSRN ( email )
No Address Available
Chao-Hui Zheng
Fujian Medical University - Department of Gastric Surgery ( email )
No.29 Xinquan Road
Fuzhou, Fujian 350001
China
+86-13365910070 (Phone)
+86-591-83320319 (Fax)
Ping Li
Fujian Medical University - Department of Gastric Surgery ( email )
No.29 Xinquan Road
Fuzhou, Fujian 350001
China
+86-591-83363366 (Phone)
+86-591-83320319 (Fax)
Jia-Bin Wang
Fujian Medical University - Fujian Medical University Union Hospital ( email )
Fuzhou, 350001
China
QiYue Chen
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
Long-Long Cao
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
Mi Lin
Fujian Medical University - Fujian Medical University Union Hospital ( email )
Fuzhou, 350001
China
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
Ru-Hong Tu
Fujian Medical University - Fujian Medical University Union Hospital ( email )
Fuzhou, 350001
China
Chang-Ming Huang
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
+86-591-83363366 (Phone)
+86-591-83320319 (Fax)
Fujian Medical University - Key Laboratory of Ministry of Education of Gastrointestinal Cancer ( email )
China
Fujian Medical University - Fujian Key Laboratory of Tumor Microbiology ( email )
Fuzhou
China
Jian-Xian Lin
Fujian Medical University - Department of Gastric Surgery ( email )
Fuzhou
China
Jian-Wei Xie (Contact Author)
Fujian Medical University - Department of Gastric Surgery ( email )
No.29 Xinquan Road
Fuzhou, Fujian Province 350001
China
