Published online Oct 14, 2022. doi: 10.3748/wjg.v28.i38.5626
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
Processing time: 124 Days and 17.2 Hours
At present, there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.
To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric cancer.
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.
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).
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.