Development of a Scoring Tool for Predicting Postoperative Length of Hospital Stay following Gastric Cancer: A Multicenter Retrospective Cohort Study

 SFX Search Permissions and Reprints(opens in new window) Article preview thumbnailAbstract Background

In the era of enhanced recovery after surgery (ERAS), accurate estimation of postoperative length of stay (p-LOS) after gastrectomy is significant for patient discharge planning and hospital bed management. However, a precise and straightforward prediction tool is lacking.

Materials and Methods

In this study, the clinical data of 924 patients who underwent gastrectomy between December 2018 and December 2023 were included from five tertiary care medical centers. There were 647 cases in the training set and 277 cases in the verification set. The linear regression analyses were used to determine the independent factors affecting p-LOS. The model's accuracy was assessed by the C-index, calibration curve, and decision curve analysis (DCA).

Results

The final model included age, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI), tumor size, and location, all of which had a significant effect on p-LOS. The nomogram comprising these five predictors exhibited sufficient predictive accuracy, with a C-index of 0.662 in the training group and of 0.664 in the verification group. The calibration curves and DCA of both groups had excellent calibration and clinical usefulness. In the high-risk group, the use of robot-assisted surgery (RAS) could effectively shorten p-LOS.

Conclusion

The developed nomogram could provide personalized risk prediction for p-LOS, and help clinicians better manage patients within ERAS.

Keywords nomogram - p-LOS - ERAS - gastric cancer - RAS Ethical Approval

All procedures were approved by the Ethics Committee of the five medical centers.


Informed Consent

Oral informed consent was obtained from all patients.


‡ These authors share first authorship.

Publication History

Received: 20 November 2025

Accepted: 29 March 2026

Article published online:
22 April 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Wenqiang Luo, Yunfeng Wang, Baiyue An, Guanjun Zhang, Xiaotong Yue, Hui Cao, Yulong Tian, Yuqi Sun. Development of a Scoring Tool for Predicting Postoperative Length of Hospital Stay following Gastric Cancer: A Multicenter Retrospective Cohort Study. Surg J (N Y) 2026; 12: a28469558.
DOI: 10.1055/a-2846-9558

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