Radiographical Evaluation of Tumor Immunosuppressive Microenvironment and Treatment Outcomes in Gastric Cancer: A Retrospective, Multicohort Study

Background The tumor immunosuppressive microenvironment can influence treatment response and outcomes. A previously validated immunosuppression scoring system (ISS) assesses multiple immune checkpoints in gastric cancer (GC) using tissue-based assays. We aimed to develop a radiological signature for...

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Published in:Annals of surgical oncology 2022-08, Vol.29 (8), p.5022-5033
Main Authors: Lin, Jian-Xian, Lin, Jun-Peng, Weng, Yong, Lv, Chen-Bin, Chen, Jian-Hua, Zhan, Chuan-Yin, Li, Ping, Xie, Jian-Wei, Wang, Jia-Bin, Lu, Jun, Chen, Qi-Yue, Cao, Long-Long, Lin, Mi, Zhou, Wen-Xing, Zhang, Xiao-Jing, Zheng, Chao-Hui, Cai, Li-Sheng, Ma, Yu-Bin, Huang, Chang-Ming
Format: Article
Language:English
Subjects:
Chemotherapy
Clinical outcomes
Epstein-Barr virus
Gastric cancer
Immune checkpoint
Immunosuppression
Medical prognosis
Medicine
Medicine & Public Health
Microenvironments
Microsatellite instability
Multivariate analysis
Oncology
Pancreatic Tumors
Patients
Prognosis
Radiomics
Surgery
Surgical Oncology
Survival
Tumors
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Summary:Background The tumor immunosuppressive microenvironment can influence treatment response and outcomes. A previously validated immunosuppression scoring system (ISS) assesses multiple immune checkpoints in gastric cancer (GC) using tissue-based assays. We aimed to develop a radiological signature for non-invasive assessment of ISS and treatment outcomes. Methods A total of 642 patients with resectable GC from three centers were divided into four cohorts. Radiomic features were extracted from portal venous–phase CT images of GC. A radiomic signature for predicting ISS (RISS) was constructed using the least absolute shrinkage and selection operator (LASSO) regression method. Moreover, we investigated the value of the RISS in predicting survival and chemotherapy response. Results The RISS, which consisted of 10 selected features, showed good discrimination of immunosuppressive status in three independent cohorts (area under the curve = 0.840, 0.809, and 0.843, respectively). Multivariate analysis revealed that the RISS was an independent prognostic factor for both disease-free survival (DFS) and overall survival (OS) in all cohorts (all p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-022-11499-z