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/
World J Gastroenterol. Oct 14, 2022; 28(38): 5626-5635 Published online Oct 14, 2022. doi: 10.3748/wjg.v28.i38.5626
Table 1 Clinicopathologic variables of 325 T2N0M0 gastric cancer patients
Variable
Overall
Adjuvant chemotherapy group
Postoperative observation group
P value
325
63
262
Age (yr) n (%)
0.609
< 40
20 (6.2)
3 (4.8)
17 (6.5)
≥ 40
305 (93.8)
60 (95.2)
245 (93.5)
Sex, n (%)
0.878
Male
250 (76.9)
48 (76.2)
202 (77.1)
Female
75 (23.1)
15 (23.8)
60 (22.9)
Smoking history, n (%)
0.363
Yes
169 (52.0)
36 (57.1)
133 (50.8)
No
156 (48.0)
27 (42.9)
129 (49.2)
Family history of gastric cancer, n (%)
0.852
Yes
24 (7.4)
5 (7.9)
19 (7.3)
No
301 (92.6)
58 (92.1)
243 (92.7)
BMI, n (%)
0.150
< 18.5 or > 23.9
176 (54.2)
29 (46.0)
147 (56.1)
18.5-23.9
149 (45.8)
34 (54.0)
115 (43.9)
Postoperative hospital stay, n (%)
0.747
≤ 14 d
285 (87.7)
56 (88.9)
229 (87.4)
> 14 d
40 (12.3)
7 (11.1)
33 (12.6)
Tumor site, n (%)
0.004
Cardia cancer
105 (32.3)
30 (47.6)
75 (28.6)
Non-cardia gastric cancer
220 (67.7)
33 (52.4)
187 (71.4)
The degree of differentiation, n (%)
0.571
Poorly differentiated
121 (37.2)
24 (38.1)
97 (37.0)
Moderately differentiated
178 (54.8)
36 (57.1)
142 (54.2)
Highly differentiated
26 (8.0)
3 (4.8)
23 (8.8)
Vascular invasion, n (%)
0.014
Yes
54 (16.6)
17 (27.0)
37 (14.1)
No
271 (83.4)
46 (73.0)
225 (85.9)
Table 2 Univariate Cox Proportional Hazards Modeling for overall survival
Clinicopathological features
HR (95%CI)
P value
Sex
Male
Reference
Female
0.278 (0.066-1.172)
P = 0.081
Smoking history
Yes
Reference
No
0.605 (0.276-1.323)
P = 0.208
Family history of gastric cancer
Yes
Reference
No
0.550 (0.075-4.057)
P = 0.558
BMI
18.5-23.9
Reference
> 23.9 or < 18.5
2.509 (1.060-5.937)
P = 0.036
Postoperative hospital stay
≤ 14 d
Reference
> 14 d
0.990 (0.298-3.292)
P = 0.987
Tumor site
Cardia cancer
Reference
Non-cardia gastric cancer
0.411 (0.192-0.878)
P = 0.022
The degree of differentiation
Poorly differentiated
Reference
Moderately differentiated
1.330 (0.574-3.082)
P = 0.507
Highly differentiated
0.857 (0.182-4.043)
P = 0.846
Vascular invasion
Yes
Reference
No
0.097 (0.044-0.212)
P < 0.001
Table 3 Multivariable Cox Proportional Hazards Modeling for overall survival
Clinicopathological features
HR (95%CI)
P value
Sex
Male
Reference
Female
0.390 (0.076-1.988)
P = 0.257
Smoking history
Yes
Reference
No
0.725 (0.308-1.710)
P = 0.463
Family history of gastric cancer
Yes
Reference
No
0.495 (0.058-4.224)
P = 0.521
BMI
18.5-23.9
Reference
> 23.9 or < 18.5
1.848 (0.760-4.490)
P = 0.175
Postoperative hospital stay
≤ 14 d
Reference
> 14 d
1.198 (0.350-4.100)
P = 0.960
Tumor site
Cardia cancer
Reference
Non-cardia gastric cancer
0.620 (0.277-1.390)
P = 0.246
The degree of differentiation
Poorly differentiated
Reference
Moderately differentiated
0.517 (0.206-1.300)
P = 0.161
Highly differentiated
0.390 (0.077-1.960)
P = 0.305
Vascular invasion
Yes
Reference
No
0.106 (0.045-0.246)
P < 0.001
Table 4 Five-year survival rates of different groups
Group
n
5-year survival rate
Log rank test
All patients
P = 0.676
Adjuvant chemotherapy
63
96%
Postoperative observation
262
90%
Risk score
P < 0.001
Score 0 group
98
92%
Score 1 group
152
95%
Score 2 group
69
80%
Score 3 group
6
50%
Score 0 group
P = 0.825
Adjuvant chemotherapy
13
92%
Postoperative observation
85
92%
Score 1 group
P = 0.308
Adjuvant chemotherapy
22
92%
Postoperative observation
130
96%
Score 2-3 group
P = 0.021
Adjuvant chemotherapy
28
95%
Postoperative observation
47
61%
Table 5 Distribution of three different risk factors in each score group
BMI < 18.5 or > 23.9
Vascular invasion
Cardia cancer
All
149
54
105
Score 0 group
0
0
0
Score 1 group
92
15
45
Score 2 group
51
33
54
Score 3 group
6
6
6
Citation: 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