European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Identifying chemotherapy benefits in high-risk patients with stage IB gastric cancer based on recurrence prediction value: A multicenter retrospective study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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He Qi-Chen, Huang Ze-Ning, Ma Yu-Bin, Zheng Chang-Yue, Sun Yu-Qin, Xie Rong-Zhen, Wang Yong-Hong, Yu Jun-Hua, Zhang Xing-Qi, Qiu Wen-Wu, He Ji-Xun, Wang Jia-Bin, Chen Qi-Yue, Cao Long-Long, Lin Mi, Tu Ru-Hong, Li Ping, Zheng Chao-Hui, Huang Chang-Ming, Lin Jian-Xian, Xie Jian-Wei
Аннотация
BACKGROUND: This study aimed to identify high-risk patients with stage IB gastric cancer who were likely to benefit from adjuvant chemotherapy (AC) through a precise assessment of recurrence risk.
METHODS: This multicenter, retrospective study analyzed patients with stage IB gastric cancer who underwent surgery between January 2010 and December 2021. High-risk factors (HR+) included poorly differentiated tumors, lymphovascular invasion, perineural invasion, or age <50 years, while those without were classified as negative (HR-). The Recurrence Prediction Value (RPV) was developed by weighting these factors.
RESULTS: Totally, 555 and 409 patients were included in the training and validation datasets, respectively. Using RPV, patients were stratified into three groups. The 3-year recurrence-free survival (RFS) rate for the HR+ with high RPV subgroup was lower than both the HR+ with low RPV and HR-with low RPV subgroups (training set: 86.7 % vs. 95.6 % vs. 98.4 %; all P < 0.001; validation set: 84.5 % vs. 94.0 % vs. 98.4 %; all P < 0.05). Subgroup analysis revealed that only the HR+ with high RPV subgroup benefited from AC, with significant RFS improvements (training set: AC vs. non-AC: 88.9 % vs. 83.9 %, P = 0.043; validation set: 92.2 % vs. 75.2 %, P = 0.003). A nomogram based on RPV for predicting recurrence demonstrated good calibration and discrimination, with C-index values of 0.748 and 0.711 for training and validation sets, respectively.
CONCLUSIONS: This study presents a method for identifying the benefit of chemotherapy in patients with stage IB gastric cancer based on RPV, which could assist surgeons in providing personalized treatment strategies for these patients.
METHODS: This multicenter, retrospective study analyzed patients with stage IB gastric cancer who underwent surgery between January 2010 and December 2021. High-risk factors (HR+) included poorly differentiated tumors, lymphovascular invasion, perineural invasion, or age <50 years, while those without were classified as negative (HR-). The Recurrence Prediction Value (RPV) was developed by weighting these factors.
RESULTS: Totally, 555 and 409 patients were included in the training and validation datasets, respectively. Using RPV, patients were stratified into three groups. The 3-year recurrence-free survival (RFS) rate for the HR+ with high RPV subgroup was lower than both the HR+ with low RPV and HR-with low RPV subgroups (training set: 86.7 % vs. 95.6 % vs. 98.4 %; all P < 0.001; validation set: 84.5 % vs. 94.0 % vs. 98.4 %; all P < 0.05). Subgroup analysis revealed that only the HR+ with high RPV subgroup benefited from AC, with significant RFS improvements (training set: AC vs. non-AC: 88.9 % vs. 83.9 %, P = 0.043; validation set: 92.2 % vs. 75.2 %, P = 0.003). A nomogram based on RPV for predicting recurrence demonstrated good calibration and discrimination, with C-index values of 0.748 and 0.711 for training and validation sets, respectively.
CONCLUSIONS: This study presents a method for identifying the benefit of chemotherapy in patients with stage IB gastric cancer based on RPV, which could assist surgeons in providing personalized treatment strategies for these patients.