title: Nomogram analysis and external validation to predict the risk of lymph node metastasis in gastric cancer.
abstract: OBJECTIVE
  To identify risk factors for lymph node metastasis using a nomogram for gastric cancer patients to predict lymph node metastasis.
  
  
  RESULTS
  The Chi-square test and the logistic regression showed that the Boarrmann type, preoperative CA199 level, T stage and N stage by CT scan were independent risk factors. The concordance index (C-index) was 0.786 in the internal validation of the Nomogram model. In the external validation, the C-index was 0.809, and the AUC was 0.894. The total accuracy of the prediction was 82.2%, and the false-negative rate was 5.4% with a cut-off value set at 0.109.
  
  
  METHODS
  The study consisted of 451 patients with a histological diagnosis of gastric cancer with 0 or 1 lymph node metastasis from the Sun Yat-sen University Cancer Center as the development set, and the validation set consisted of 186 gastric cancer patients from the Sixth Affiliated Hospital of Sun Yat-Sen University. A Chi-square test and a logistic regression analysis were used to compare the clinicopathological variables and lymph node metastasis. The C-index and ROC curve were computed for comparisons of the nomogram's predictive ability.
  
  
  CONCLUSIONS
  We developed and validated a nomogram to predict lymph node metastasis in gastric cancer before surgery. This nomogram can be broadly applied, even in general hospitals, and is useful for decisions regarding treatment programs for patients.
authors.affiliation: The 6th Affiliated Hospital, Sun Yat-Sen University, YuanCun ErHeng Road, TianHe District, 510655, Guangzhou, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
authors.forename: Run-Cong
authors.initials: RC
authors.lastname: Nie
authors.affiliation: Department of Intensive Care Unit, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: OuYang
authors.affiliation: Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
authors.forename: Yuan-Fang
authors.initials: YF
authors.lastname: Li
authors.affiliation: The 6th Affiliated Hospital, Sun Yat-Sen University, YuanCun ErHeng Road, TianHe District, 510655, Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Zhou
authors.affiliation: Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
authors.forename: YingBo
authors.initials: Y
authors.lastname: Chen
authors.affiliation: The 6th Affiliated Hospital, Sun Yat-Sen University, YuanCun ErHeng Road, TianHe District, 510655, Guangzhou, China.
authors.forename: Jun-Sheng
authors.initials: JS
authors.lastname: Peng
mesh_terms: D019540:Area Under Curve; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D049451:Nomograms; D012372:ROC Curve; D012306:Risk; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: gastric cancer; lymph node metastasis; nomogram; risk