Indications for adjuvant chemotherapy in patients with AJCC stage IIa T3N0M0 and T1N2M0 gastric cancer-an east and west multicenter study

• Published in: BMC gastroenterology 2019-12, Vol.19 (1), p.205-205, Article 205
• Main Authors: Huang, Ze-Ning, Desiderio, Jacopo, Chen, Qi-Yue, Zheng, Chao-Hui, Li, Ping, Xie, Jian-Wei, Wang, Jia-Bin, Lin, Jian-Xian, Lu, Jun, Cao, Long-Long, Lin, Mi, Tu, Ru-Hong, Lin, Ju-Li, Zheng, Hua-Long, Huang, Chang-Ming
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adjuvant chemotherapy; Age; Aged; Analysis; Cancer; Cancer patients; Cancer research; Cancer treatment; Care and treatment; Chemotherapy; Chemotherapy, Adjuvant; China - epidemiology; Datasets; Datasets as Topic; Decision curve; Dissection; Epidemiology; Female; Gastrectomy; Gastric cancer; Gastroenterology; Gender; Histology; Humans; Intelligence gathering; Italy - epidemiology; Lymph Node Excision; Male; Medical research; Multiple regression analysis; Nomograms; Operating systems (Software); Patients; Prediction models; Regression analysis; Risk Factors; SEER Program; Stomach cancer; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - therapy; Surgery; T3N0M0 and T1N2M0; Tumors; United States - epidemiology
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-019-1096-8

To determine the indications for adjuvant chemotherapy (AC) in patients with stage IIa gastric cancer (T3N0M0 and T1N2M0) according to the 7th American Joint Committee on Cancer (AJCC). A total of 1593 patients with T3N0M0 or T1N2M0 stage gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database for the period 1988.1-2012.12. Cox multiple regression, nomogram and decision curve analyses were performed. External validation was performed using databases of the Fujian Medical University Union Hospital (FJUUH) (n = 241) and Italy IMIGASTRIC center (n = 45). Cox multiple regression analysis showed that the risk factors that affected OS in patients receiving AC were age > 65 years old, T1N2M0, LN dissection number ≤ 15, tumor size > 20 mm, and nonadenocarcinoma. A nomogram was constructed to predict 5-year OS, and the patients were divided into those predicted to receive a high benefit (points ≤ 188) or a low benefit from AC (points > 188) according to a recursive partitioning analysis. OS was significantly higher for the high-benefit patients in the SEER database and the FJUUH dataset than in the non-AC patients (Log-rank