To study the value of the ratio of the red blood cell distribution width (RDW) to the mean corpuscular volume (MCV) (RMR) in predicting the efficacy of adjuvant chemotherapy (AC) in residual gastric cancer (RGC).
A total of 379 patients who underwent resection for RGC at 7 hospitals in China from January 2004 to January 2016 were analyzed. A nomogram predicts survival was established to evaluate the effect of RMR through a decision curve.
According to the RMR cut-off point (0.177), all patients were divided into Group L (RMR<0.177) (n = 179) and Group H (RMR ≥ 0.177) (n = 160). Patients with stage II and III disease with a high RMR who received AC had a significantly better 3-year OS than those who did not receive AC (P = 0.048 and 0.044), while AC had no significant effect on the survival of patients with low RMR. The independent prognostic factors for OS in patients with RGC who underwent AC were used to establish a nomogram. The C-index was 0.795, and the decision threshold was 0-85%. According to the nomogram, patients were divided into low-benefit patients with AC (point < 102 points) and high-benefit patients with AC (point ≥ 102 points).
The predictive model based on RMR in this study can provide a simple and accurate indication for postoperative AC in patients with RGC. It is recommended that postoperative AC be administered to high-benefit patients with a score of ≥102 on the nomogram.
The authors.
Scientific and Technological Innovation Joint Capital Projects of Fujian Province.
All authors have declared no conflicts of interest.