ArticleWorld journal of surgical oncology2026
A nomogram integrating p53 and Ki-67 expression for predicting recurrence risk in postoperative early gastric cancer.
Article in World journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAberrant expression of p53 and elevated Ki-67 proliferation index have been associated with tumor progression and recurrence; however, their prognostic value in postoperative early gastric cancer (EGC) remains to be fully established. This study aimed to develop and internally validate a nomogram integrating these biomarkers for individualized recurrence risk prediction.
methodsWe retrospectively analyzed 536 EGC patients from a single institution between January 2017 and October 2018, with follow-up through June 2025. Patients were randomly divided into training (n = 375) and validation (n = 161) cohorts. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic predictors. Model performance was assessed using time-dependent AUC, integrated Brier score, calibration curves, and decision curve analysis.
resultsFive independent factors were identified: Helicobacter pylori infection (HR = 1.83), Ki-67 > 30% (HR = 4.28), lymphovascular invasion (HR = 1.91), perineural invasion (HR = 4.37), and p53 (reference: mutant, HR = 0.37). The nomogram achieved good discriminative ability (1-year AUC: 0.861 training, 0.878 validation; 5-year AUC: 0.808, 0.788). Nomogram-based risk stratification demonstrated significant differences in survival outcomes (log-rank P < 0.001).
conclusionThis nomogram demonstrates potential utility for recurrence risk stratification in postoperative EGC patients. However, the model requires external validation in independent, multi-center cohorts before clinical implementation. The single-center retrospective design and relatively short follow-up represent important limitations.
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