Research Information System
JOURNAL OF GASTROINTESTINAL CANCER, vol.56, no.2025, pp.1-10, 2025 (ESCI)
Abstract
Purpose The aim of this study was to identify prognostic factors influencing overall survival (OS) in patients with gastric
cancer treated with adjuvant chemoradiotherapy (CRT) and to develop a predictive model.
Methods We retrospectively evaluated 245 non-metastatic gastric cancer patients who received adjuvant CRT or radiotherapy
from 2010 to 2020. Survival analyses were performed using the Kaplan–Meier method. Prognostic factors were identified
through univariate and multivariate Cox regression analyses. A nomogram was constructed based on significant predictive
factors for OS, including lymph node ratio, T classification, tumor location, and local recurrence.
Results The median follow-up duration was 41.5 months (range, 6–144.8 months). The 2- and 5-year OS and progression-free
survival were 77% and 53% and 64% and 49%, respectively. In multivariate analysis, tumor location (distal vs. proximal),
pT classification (pT1-2 vs. pT3-4), lymph node ratio (< 0.18 vs. ≥ 0.18), and presence of local recurrence were independent
prognostic factors for OS. The optimal cut-off value for the total nomogram score predicting OS was 116 points. Patients
with < 116 points had 2- and 5-year OS rates of 87% and 73%, respectively, compared to 67% and 30% for those with ≥ 116
points.
Conclusion A nomogram was constructed incorporating lymph node ratio, T classification, tumor site, and local recurrence
for gastric cancer patients receiving adjuvant CRT. Patients with a total score below 116 demonstrated higher survival rates.
This nomogram may aid in defining optimal follow-up intervals.
Keywords Gastric cancer · Nomogram · Adjuvant chemoradiotherapy · Lymph node ratio · Local recurrence