Xu Q, Kang WZ, Xiong JP, Shao XX, Li WK, Hu HT, Tian YT. A new scoring system to evaluate adjuvant chemotherapy for patients with T2N0M0 gastric cancer after D2 gastrectomy. World J Gastroenterol 2022; 28(38): 5626-5635 [PMID: 36304088 DOI: 10.3748/wjg.v28.i38.5626]
Corresponding Author of This Article
Yan-Tao Tian, PhD, Professor, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. tianyantao@cicams.ac.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Quan Xu, Wen-Zhe Kang, Jian-Ping Xiong, Xin-Xin Shao, Wei-Kun Li, Hai-Tao Hu, Yan-Tao Tian, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Xu Q and Kang WZ contributed equally to this work; Tian YT and Xu Q designed the research; Kang WZ, Xiong JP, and Shao XX analyzed the data and wrote the paper; Li WK and Hu HT collected the patient’s clinical data.
Supported bythe National Natural Science Foundation of China, No. 82072734.
Institutional review board statement: The study was reviewed and approved by the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Institutional Review Board (Approval No. 17-156/1412).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the author at kwz@whu.edu.cn.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Tao Tian, PhD, Professor, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. tianyantao@cicams.ac.cn
Received: June 9, 2022 Peer-review started: June 9, 2022 First decision: August 1, 2022 Revised: August 19, 2022 Accepted: September 21, 2022 Article in press: September 21, 2022 Published online: October 14, 2022
Abstract
BACKGROUND
At present, there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.
AIM
To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric cancer.
METHODS
We identified 325 patients with pathological T2N0M0 stage primary gastric cancer at the National Cancer Center between 2011 and 2018. Univariate and multivariate Cox regression analyses were performed to predict factors affecting prognosis. Vascular invasion, tumor site, and body mass index were assessed, and a scoring system was established. We compared the survival outcomes and benefits of adjuvant chemotherapy between the different subgroups.
RESULTS
Five-year survival rates of the score 0, 1, 2, and 3 groups were 92%, 95%, 80%, and 50%, respectively (P < 0.001). In the score 2-3 group, five-year survival rates for patients in the adjuvant chemotherapy group and postoperative observation group were 95% and 61%, respectively (P = 0.021).
CONCLUSION
For patients with T2N0M0 stage gastric cancer and two or more risk factors, adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.
Core Tip: It is controversial whether adjuvant chemotherapy is necessary for stage T2N0M0 gastric cancer. In our study, we assessed the risk score of patients with pathologic T2N0M0 gastric cancer after D2 gastrectomy, based on clinicopathological factors, and identified a high-risk subgroup that could benefit from adjuvant chemotherapy. For patients with T2N0M0 stage gastric cancer with two or more risk factors, adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.
