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Background <p>Neoadjuvant chemotherapy (NAC) combined with gastrectomy has been a standard therapeutic strategy for resectable gastric cancer (GC). However, it remains unclear whether postoperative adjuvant chemotherapy (AC) brings better survival in ypTNM stage I GC patients.</p> Methods <p>Data on ypTNM stage I GC patients with or without AC following systemic NAC and radical gastrectomy were retrospectively retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2021. Inverse probability of treatment weighting (IPTW) was used to balance covariates. Overall survival (OS) and cancer-specific survival (CSS) were assessed through Kaplan-Meier and Cox proportional hazards models. Two nomograms were developed to predict OS and CSS of patients with ypTNM stage I GC who received AC.</p> Results <p>661 patients met the inclusion criteria, 230 received AC and 431 were AC nonuser. AC was significantly associated with improved OS (weighted HR = 0.63, 95% CI: 0.43–0.92) but not statistically significant for CSS (weighted HR = 0.73, 95% CI: 0.46–1.17) after IPTW adjustment. Age, tumor diameter, and primary site were also independent predictors of survival. Subgroup analysis revealed that patients with non-proximal GC benefitted more from AC. The survival prediction models demonstrated good calibration and discrimination, with the C-indexes for OS were 0.75 and 0.79 for CSS.</p> Conclusion <p>Patients with ypTNM stage I GC might benefit from postoperative AC compared with non-AC. Nomograms showed better predictive value for evaluating the prognosis of ypTNM stage I GC patients who received AC.</p>

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The association of survival with adjuvant chemotherapy in patients with ypTNM stage I gastric cancer after neoadjuvant chemotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月31日

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  • Yuchen Liu,
  • Hao Cui,
  • Liqiang Song,
  • Zhen Yuan,
  • Ruonan An,
  • Jinghang Wang,
  • Rui Li,
  • Lin Chen,
  • Jianxin Cui,
  • Bo Wei

摘要

Background

Neoadjuvant chemotherapy (NAC) combined with gastrectomy has been a standard therapeutic strategy for resectable gastric cancer (GC). However, it remains unclear whether postoperative adjuvant chemotherapy (AC) brings better survival in ypTNM stage I GC patients.

Methods

Data on ypTNM stage I GC patients with or without AC following systemic NAC and radical gastrectomy were retrospectively retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2021. Inverse probability of treatment weighting (IPTW) was used to balance covariates. Overall survival (OS) and cancer-specific survival (CSS) were assessed through Kaplan-Meier and Cox proportional hazards models. Two nomograms were developed to predict OS and CSS of patients with ypTNM stage I GC who received AC.

Results

661 patients met the inclusion criteria, 230 received AC and 431 were AC nonuser. AC was significantly associated with improved OS (weighted HR = 0.63, 95% CI: 0.43–0.92) but not statistically significant for CSS (weighted HR = 0.73, 95% CI: 0.46–1.17) after IPTW adjustment. Age, tumor diameter, and primary site were also independent predictors of survival. Subgroup analysis revealed that patients with non-proximal GC benefitted more from AC. The survival prediction models demonstrated good calibration and discrimination, with the C-indexes for OS were 0.75 and 0.79 for CSS.

Conclusion

Patients with ypTNM stage I GC might benefit from postoperative AC compared with non-AC. Nomograms showed better predictive value for evaluating the prognosis of ypTNM stage I GC patients who received AC.