Chen TL, Yu XQ. Value of gastric cancer clinical decision support system in a single-center clinical application. World J Gastrointest Oncol 2026; 18(4): 115146 [DOI: 10.4251/wjgo.v18.i4.115146]
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Apr 15, 2026 (publication date) through Apr 11, 2026
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World Journal of Gastrointestinal Oncology
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1948-5204
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Chen TL, Yu XQ. Value of gastric cancer clinical decision support system in a single-center clinical application. World J Gastrointest Oncol 2026; 18(4): 115146 [DOI: 10.4251/wjgo.v18.i4.115146]
World J Gastrointest Oncol. Apr 15, 2026; 18(4): 115146 Published online Apr 15, 2026. doi: 10.4251/wjgo.v18.i4.115146
Value of gastric cancer clinical decision support system in a single-center clinical application
Tian-Li Chen, Xi-Qiu Yu
Tian-Li Chen, Xi-Qiu Yu, Department of Gastroenterology, Shenzhen Luohu People’s Hospital, Shenzhen Luohu Hospital Group, Shenzhen 518001, Guangdong Province, China
Tian-Li Chen, College of Medicine, Shantou University, Shantou 515000, Guangdong Province, China
Author contributions: Chen TL participated in the design of the research program, was responsible for data collection and collation, the implementation of primary statistical analyses, the creation of charts, the writing of the first draft of the original paper, and the subsequent revisions and responses to review comments; Yu XQ participated in the design and planning of the research, provided key methodological guidance, ensured that the research conformed to ethical norms, obtained research resources and financial support, supervised the whole process of data analysis and result interpretation, critically reviewed the first draft of the paper, revised and finalized the important content, and was responsible for all academic communication matters; all of the authors read and approved the final version of the manuscript to be published.
Supported by Shenzhen Science and Technology Innovation Bureau, No. GJHZ20220913144211022.
Institutional review board statement: The study has been approved by the Ethics Committee of Shenzhen Luohu People’s Hospital (No. 2025-LHQRMYY-KYLL-052).
Informed consent statement: The study has been exempted from informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: No additional data are available.
Received: October 13, 2025 Revised: January 6, 2026 Accepted: February 5, 2026 Published online: April 15, 2026 Processing time: 181 Days and 13.9 Hours
Abstract
BACKGROUND
The incidence and mortality of gastric cancer remain among the highest of all malignant tumors, and there is an urgent need for both standardized and individualized clinical decision-making. Clinical decision support systems (CDSS) based on artificial intelligence have been increasingly integrated into the entire process of gastric cancer diagnosis and treatment. However, their concordance with actual clinical decisions in complex cases requires further validation.
AIM
To develop a gastric cancer CDSS grounded in widely adopted international guidelines and to evaluate its clinical applicability.
METHODS
This retrospective study included 156 patients with gastric cancer who were treated at Shenzhen Luohu People’s Hospital between January 1, 2015 and December 31, 2024. The concordance between CDSS-recommended treatment regimens and actual clinical decisions was assessed. Categorical variables were expressed as percentages and compared using the χ2 test or Fisher’s exact test, as appropriate.
RESULTS
The overall concordance rate among the 156 patients was 90.4%. Concordance was 100% for patients with stage 0, I, and II; 89.8% for stage III; and 83.6% for stage IV. When comparing early-stage to mid-stage (0-III) with late-stage (IV) gastric cancer, the concordance rates were 94.7% and 83.6%, respectively (P < 0.05). By treatment modality, concordance was high for surgical treatment (97.6%), neoadjuvant therapy (100%), and supportive therapy (100%), but lower for palliative systemic therapy (77.8%) and adjuvant therapy (72.7%, P < 0.05).
CONCLUSION
CDSS demonstrates significant advantages in managing early-stage gastric cancer through standardized treatment approaches. However, improving concordance in complex and personalized cases remains a critical challenge.
Core Tip: The clinical decision support system (CDSS) is a cognitive computing platform designed to simulate clinician decision-making processes. Based on widely used international guidelines for the treatment of gastric cancer, a CDSS specifically for gastric cancer was developed. A single-center retrospective study was conducted at Shenzhen Luohu People’s Hospital. The results indicate that the CDSS demonstrates high concordance with multidisciplinary team recommendations in patients undergoing early-stage and standardized treatments. However, challenges remain in managing complex and personalized cases of gastric cancer, which will be a key focus for future system optimization.
