Background. Neoadjuvant chemotherapy (NAC) with subsequent radical surgery has become a popular treatment modality for advanced gastric cancer (AGC) worldwide. However, the survival benefit is still controversial, and prognostic factors remain undetermined. Aim. To identify clinical parameters that are associated with the survival of AGC patients after NAC and radical surgery and to establish a nomogram integrating multiple factors to predict survival. Methods. We reviewed the medical profiles of 215 AGC patients who received NAC and radical resection, and clinical parameters concerning NAC, surgery, pathological findings, and adjuvant chemotherapy were analyzed using a Cox regression model to determine their impact on survival. Based on these factors, a nomogram was developed and validated. Results. The overall 1-year and 3-year survival rates were 85.8% and 55.6%, respectively. Younger age (<60 years old), increased examined lymph nodes (exLNs), successful R0 resection, the achievement of pathological complete response (pCR), and acceptance of adjuvant chemotherapy were positive predictors of survival. The C-index of the established nomogram was 0.785. The area under receiver operating curve (ROC) at 1/3 years of prediction was 0.694/0.736, respectively. The model showed an ideal calibration following internal bootstrap validation. Conclusion. A nomogram predicting survival after NAC and surgery was established. Since this nomogram exhibited satisfactory and stable predictive power, it can be inferred that this is a practical tool for predicting AGC patient survival after NAC and radical surgery.

中文翻译：

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预测晚期胃癌新辅助化疗和根治性手术后生存的列线图

背景。新辅助化疗（NAC）和随后的根治性手术已成为全球晚期胃癌（AGC）的流行治疗方式。然而，生存获益仍有争议，预后因素仍未确定。瞄准。确定与 NAC 和根治性手术后 AGC 患者生存相关的临床参数，并建立一个综合多因素预测生存的列线图。方法. 我们回顾了接受 NAC 和根治性切除术的 215 名 AGC 患者的医疗资料，并使用 Cox 回归模型分析了有关 NAC、手术、病理结果和辅助化疗的临床参数，以确定它们对生存的影响。基于这些因素，开发并验证了列线图。结果. 总体 1 年和 3 年生存率分别为 85.8% 和 55.6%。年龄较小（<60 岁）、检查的淋巴结（exLNs）增多、R0 切除成功、达到病理完全缓解（pCR）和接受辅助化疗是生存的积极预测因素。已建立的列线图的 C 指数为 0.785。预测 1/3 年的受试者工作曲线下面积 (ROC) 分别为 0.694/0.736。该模型在内部自举验证后显示出理想的校准。结论。建立了预测 NAC 和手术后生存率的列线图。由于该列线图表现出令人满意且稳定的预测能力，因此可以推断这是预测 NAC 和根治性手术后 AGC 患者存活率的实用工具。