A Prognostic Nomogram for Elderly Patients with Advanced Gastric Cancer: A Retrospective Study

A Prognostic Nomogram for Elderly Patients with Advanced Gastric Cancer: A Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Prognostic Nomogram for Elderly Patients with Advanced Gastric Cancer: A Retrospective Study Honghong Zhang, Jia Wei, Jiaguang Zhang, Jie Tang, Changchun Sun, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8217980/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Gastric cancer (GC), often diagnosed at an advanced stage, predominantly affects elderly individuals. This study aimed to analyze the clinicopathological features and prognostic factors in elderly patients with advanced gastric cancer (AGC) and to construct a nomogram for individualized survival prediction. Methods We retrospectively analyzed data from 428 patients with advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma who received first-line chemo-immunotherapy at JiangSu Province Hospital between June 2019 and July 2024. Patients were categorized into elderly (> 65 years) and younger (≤ 65 years) groups based on age. Clinicopathological features and survival outcomes were assessed through medical record reviews and follow-up examinations. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier methods, and univariate and multivariate Cox regression analyzes were performed to evaluate the impact of clinical characteristics on OS in elderly patients with AGC. Results The study included 222 elderly (> 65 years) and 206 younger (≤ 65 years) AGC patients. Significant differences (P < 0.05) in baseline characteristics were observed between the two age groups regarding body mass index (BMI), Eastern Cooperative Oncology Group Performance Status(ECOG PS), Lauren classification, presence of peritoneal metastases, primary tumor site, tumor differentiation, hemoglobin, leukocyte count, and albumin levels. The median PFS was significantly longer in the elderly group (341 days) than in the younger group (282 days) (P = 0.021). However, no significant difference was observed in median OS between the two groups (584 vs. 596 days, P = 0.405). In elderly patients with AGC, univariate analysis identified ECOG PS, human epidermal growth factor receptor 2 (HER2) status, peritoneal metastases, Lauren classification, tumor differentiation, albumin, Carbohydrate Antigen 19 − 9 (CA19-9), and Carbohydrate Antigen 72 − 4 (CA72-4) as significant prognostic factors; multivariate analysis further established ECOG PS, HER2 status, tumor differentiation, Lauren classification, and albumin as independent prognostic factors for OS. Conclusion ECOG PS, HER2 status, tumor differentiation, Lauren classification, and serum albumin level were identified as independent prognostic factors in elderly patients with AGC. Based on these findings, nutritional intervention emerges as a promising therapeutic target to improve survival outcomes in this population. advanced gastric cancer aged COX regression prediction model risk factors survival analysis Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8217980","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":562434176,"identity":"d12722e4-664c-4092-b621-84dab8fc3f4b","order_by":0,"name":"Honghong Zhang","email":"","orcid":"","institution":"The Affiliated Taizhou People's Hospital of Nanjing Medical University, Nanjing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Honghong","middleName":"","lastName":"Zhang","suffix":""},{"id":562434177,"identity":"b5c84533-c8e3-4ceb-9f3a-27d36e1a66e6","order_by":1,"name":"Jia 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Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"advanced gastric cancer, aged, COX regression, prediction model, risk factors, survival analysis","lastPublishedDoi":"10.21203/rs.3.rs-8217980/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8217980/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eGastric cancer (GC), often diagnosed at an advanced stage, predominantly affects elderly individuals. This study aimed to analyze the clinicopathological features and prognostic factors in elderly patients with advanced gastric cancer (AGC) and to construct a nomogram for individualized survival prediction.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe retrospectively analyzed data from 428 patients with advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma who received first-line chemo-immunotherapy at JiangSu Province Hospital between June 2019 and July 2024. Patients were categorized into elderly (\u0026gt;\u0026thinsp;65 years) and younger (\u0026le;\u0026thinsp;65 years) groups based on age. Clinicopathological features and survival outcomes were assessed through medical record reviews and follow-up examinations. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier methods, and univariate and multivariate Cox regression analyzes were performed to evaluate the impact of clinical characteristics on OS in elderly patients with AGC.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe study included 222 elderly (\u0026gt;\u0026thinsp;65 years) and 206 younger (\u0026le;\u0026thinsp;65 years) AGC patients. Significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in baseline characteristics were observed between the two age groups regarding body mass index (BMI), Eastern Cooperative Oncology Group Performance Status(ECOG PS), Lauren classification, presence of peritoneal metastases, primary tumor site, tumor differentiation, hemoglobin, leukocyte count, and albumin levels. The median PFS was significantly longer in the elderly group (341 days) than in the younger group (282 days) (P\u0026thinsp;=\u0026thinsp;0.021). However, no significant difference was observed in median OS between the two groups (584 vs. 596 days, P\u0026thinsp;=\u0026thinsp;0.405). In elderly patients with AGC, univariate analysis identified ECOG PS, human epidermal growth factor receptor 2 (HER2) status, peritoneal metastases, Lauren classification, tumor differentiation, albumin, Carbohydrate Antigen 19\u0026thinsp;\u0026minus;\u0026thinsp;9 (CA19-9), and Carbohydrate Antigen 72\u0026thinsp;\u0026minus;\u0026thinsp;4 (CA72-4) as significant prognostic factors; multivariate analysis further established ECOG PS, HER2 status, tumor differentiation, Lauren classification, and albumin as independent prognostic factors for OS.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eECOG PS, HER2 status, tumor differentiation, Lauren classification, and serum albumin level were identified as independent prognostic factors in elderly patients with AGC. Based on these findings, nutritional intervention emerges as a promising therapeutic target to improve survival outcomes in this population.\u003c/p\u003e","manuscriptTitle":"A Prognostic Nomogram for Elderly Patients with Advanced Gastric Cancer: A Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-19 03:13:32","doi":"10.21203/rs.3.rs-8217980/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f309bc4d-f5be-4087-bbae-815987ab01a8","owner":[],"postedDate":"December 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-14T10:11:31+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-19 03:13:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8217980","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8217980","identity":"rs-8217980","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}