ORIGINAL RESEARCH article
Front. Mol. Biosci.
Sec. Molecular Diagnostics and Therapeutics
This article is part of the Research TopicExploring the Correlation and Heterogeneity Between Acute and Chronic Diseases: Diagnostic and Therapeutic PerspectivesView all 10 articles
A Prognostic Nomogram for Predicting Overall Survival in Gastric Signet Ring Cell Carcinoma Patients: a SEER Database and Chinese Registry Analysis
Provisionally accepted
- Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Purpose: Gastric signet ring cell carcinoma (GSRC) is a distinct gastric cancer (GC) subtype. This study aimed to develop and validate a nomogram to predict overall survival (OS) and guide clinical decision-making. Methods: This study included 2,203 GSRC patients from the SEER database (2010–2019), randomly split into a modeling cohort (n=1,542) and an internal validation cohort (n=661). An external cohort of 74 patients from the Second Affiliated Hospital of Nanjing Medical University (2019–2024; median follow-up 34 months) was used for validation. Predictor variables—age, sex, chemotherapy, lymph node ratio (LNR), T and M categories, tumor size, and tumor number—were included in a cox proportional hazard model. A nomogram was derived from the cox model and internally validated using 1,000 bootstrap resamples. Discrimination, calibration, and decision curve analysis (DCA) evaluated model performance. Results: The nomogram included age, chemotherapy, LNR, T and M categories, and tumor size. In the modeling cohort, time-dependent area under the receiver operating characteristic curve (AUC) was 0.79, 0.85, and 0.85 at 12, 36, and 60 months; internal validation AUCs were 0.79, 0.85, and 0.85. In the external cohort, AUC at 36 months was 0.91 (primary horizon), with exploratory IPCW-AUCs of 1.00 at 12 and 60 months due to class imbalance. Calibration showed close agreement between predicted and observed OS, and DCA demonstrated clinical net benefit across relevant thresholds. Conclusion: This study developed a nomogram for OS prediction in GSRC patients, supporting risk stratification and clinical decision-making.
Keywords: Gastric signet ring cell carcinoma, gastric cancer, SEER database, nomogram, survival analysis, lymph node ratio
Received: 12 Sep 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Wu, Wang, Chen, Nie, Xia, Li, Deng and Ji. 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:
Quanpeng Li, quanpenglidr@163.com
Xueting Deng, xtdeng@njmu.edu.cn
Guozhong Ji, jgzzl@163.com
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