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Abstract：
UNASSIGNED: The combination of neoadjuvant immunotherapy and chemotherapy (NICT) has become a common treatment regimen for locally advanced gastric cancer (LAGC). However, the safety and efficacy of radical gastrectomy following NICT (NICT-G) remain controversial. This study aimed to analyze the risk factors influencing postoperative complications (POCs) after NICT-G. Additionally, it aimed to construct a nomogram to provide a clinical reference for predicting POCs.
UNASSIGNED: This study included 177 patients who received NICT-G at the Chinese PLA General Hospital First Medical Center from January 2020 to January 2024. Univariable and multivariable logistic regression models were used to evaluate the risk factors influencing POCs, and a nomogram model was constructed. To evaluate the discrimination and accuracy of the nomogram model, the area under the receiver operating characteristic curve (AUC) and the calibration curve were measured.
UNASSIGNED: In 177 patients who received NICT-G, the pathological complete response and major pathological response rates were 15.8% and 45.2%, respectively, whereas the rates of the overall and severe treatment-related adverse events were 71.8% and 15.8%, respectively. In addition, 43 (24.3%) patients developed overall POCs (Clavien-Dindo classification ≥ II). Univariable and multivariable logistic analyses showed that age ≥70 years, greater estimated blood loss, platelet/lymphocyte ratio (PLR) ≤196, neutrophil/lymphocyte ratio (NLR) >1.33, non-R0 resection, and body mass index (BMI) < 18.5 kg/m2 were independent risk factors for overall POCs (p < 0.05). The nomogram model developed using the abovementioned variables showed that the AUC (95% confidence interval [CI]) was 0.808 (95% CI): 0.731-0.885 in predicting the POC risk. The calibration curves showed that the prediction curve of the nomogram was a good fit for the actual POCs (Hosmer-Lemeshow test: χ2 = 5.76, P = 0.451).
UNASSIGNED: The independent risk factors for overall POCs in the NICT-G were age ≥ 70 years, greater estimated blood loss, PLR ≤ 196, NLR > 1.33, non-R0 resection, and BMI < 18.5 kg/m2. The nomogram model developed based on the abovementioned indicators showed better accuracy in predicting the POC risk.
UNASSIGNED: This study included 177 patients who received NICT-G at the Chinese PLA General Hospital First Medical Center from January 2020 to January 2024. Univariable and multivariable logistic regression models were used to evaluate the risk factors influencing POCs, and a nomogram model was constructed. To evaluate the discrimination and accuracy of the nomogram model, the area under the receiver operating characteristic curve (AUC) and the calibration curve were measured.
UNASSIGNED: In 177 patients who received NICT-G, the pathological complete response and major pathological response rates were 15.8% and 45.2%, respectively, whereas the rates of the overall and severe treatment-related adverse events were 71.8% and 15.8%, respectively. In addition, 43 (24.3%) patients developed overall POCs (Clavien-Dindo classification ≥ II). Univariable and multivariable logistic analyses showed that age ≥70 years, greater estimated blood loss, platelet/lymphocyte ratio (PLR) ≤196, neutrophil/lymphocyte ratio (NLR) >1.33, non-R0 resection, and body mass index (BMI) < 18.5 kg/m2 were independent risk factors for overall POCs (p < 0.05). The nomogram model developed using the abovementioned variables showed that the AUC (95% confidence interval [CI]) was 0.808 (95% CI): 0.731-0.885 in predicting the POC risk. The calibration curves showed that the prediction curve of the nomogram was a good fit for the actual POCs (Hosmer-Lemeshow test: χ2 = 5.76, P = 0.451).
UNASSIGNED: The independent risk factors for overall POCs in the NICT-G were age ≥ 70 years, greater estimated blood loss, PLR ≤ 196, NLR > 1.33, non-R0 resection, and BMI < 18.5 kg/m2. The nomogram model developed based on the abovementioned indicators showed better accuracy in predicting the POC risk.
摘要：
■新辅助免疫疗法和化学疗法（NICT）的结合已成为局部晚期胃癌（LAGC）的常用治疗方案。然而,NICT后胃癌根治术(NICT-G)的安全性和有效性仍存在争议.本研究旨在分析影响NICT-G术后并发症（POCs）的危险因素。此外,旨在构建列线图，为预测POCs提供临床参考。
■这项研究包括2020年1月至2024年1月在中国人民解放军总医院第一医学中心接受NICT-G治疗的177名患者。单变量和多变量logistic回归模型用于评估影响POCs的危险因素，并建立了列线图模型。为了评估列线图模型的区分度和准确性，测量受试者工作特征曲线下面积(AUC)和校准曲线.
■在177名接受NICT-G的患者中，病理完全缓解率和主要病理缓解率分别为15.8%和45.2%,分别,而总体和严重治疗相关不良事件的发生率分别为71.8%和15.8%，分别。此外,43例（24.3%）患者出现总体POC（Clavien-Dindo分类≥II）。单变量和多变量逻辑分析表明，年龄≥70岁，估计失血更多，血小板/淋巴细胞比值（PLR）≤196，中性粒细胞/淋巴细胞比值（NLR）>1.33，非R0切除，体重指数（BMI）<18.5kg/m2是总体POC的独立危险因素（p<0.05）。使用上述变量建立的列线图模型显示，预测POC风险的AUC（95％置信区间[CI]）为0.808（95％CI）：0.731-0.885。校准曲线表明，列线图的预测曲线与实际POC拟合良好（Hosmer-Lemeshow检验：χ2=5.76，P=0.451）。
■NICT-G中总体POC的独立危险因素是年龄≥70岁，估计失血更多，PLR≤196，NLR>1.33，非R0切除，BMI<18.5kg/m2。基于上述指标建立的列线图模型在预测POC风险方面显示出更好的准确性。
■这项研究包括2020年1月至2024年1月在中国人民解放军总医院第一医学中心接受NICT-G治疗的177名患者。单变量和多变量logistic回归模型用于评估影响POCs的危险因素，并建立了列线图模型。为了评估列线图模型的区分度和准确性，测量受试者工作特征曲线下面积(AUC)和校准曲线.
■在177名接受NICT-G的患者中，病理完全缓解率和主要病理缓解率分别为15.8%和45.2%,分别,而总体和严重治疗相关不良事件的发生率分别为71.8%和15.8%，分别。此外,43例（24.3%）患者出现总体POC（Clavien-Dindo分类≥II）。单变量和多变量逻辑分析表明，年龄≥70岁，估计失血更多，血小板/淋巴细胞比值（PLR）≤196，中性粒细胞/淋巴细胞比值（NLR）>1.33，非R0切除，体重指数（BMI）<18.5kg/m2是总体POC的独立危险因素（p<0.05）。使用上述变量建立的列线图模型显示，预测POC风险的AUC（95％置信区间[CI]）为0.808（95％CI）：0.731-0.885。校准曲线表明，列线图的预测曲线与实际POC拟合良好（Hosmer-Lemeshow检验：χ2=5.76，P=0.451）。
■NICT-G中总体POC的独立危险因素是年龄≥70岁，估计失血更多，PLR≤196，NLR>1.33，非R0切除，BMI<18.5kg/m2。基于上述指标建立的列线图模型在预测POC风险方面显示出更好的准确性。
