{"title":"Long-term survival analysis after radical gastrectomy for Epstein-Barr virus-associated gastric cancer: A multicenter study","authors":"Rong-Zhen Xie , Ze-Ning Huang , Xing-Qi Zhang , Yu-Qin Sun , Jiao-Bao Huang , Qi-Yue Chen , Jian-Wei Xie , Chao-Hui Zheng , Chang-Ming Huang , Jian-Xian Lin , Ping Li","doi":"10.1016/j.ejso.2025.109737","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The prognosis of Epstein-Barr virus-associated gastric cancer (EBVaGC)needs to be validated by high-quality studies. This study aimed to assess the long-term survival of EBVaGC patients after radical gastrectomy using multicenter data to explore the potential value of EBV infection status as a prognostic predictor.</div></div><div><h3>Methods</h3><div>We analyzed the clinical data of patients with EBVaGC and Epstein-Barr virus-negative gastric cancer (EBVnGC) who underwent radical gastrectomy from January 2013 to July 2020. The Kaplan-Meier method and Cox regression analysis were used to evaluate overall survival (OS) and disease-free survival (DFS). A Random Survival Forest (RSF) model was constructed to predict the prognosis.</div></div><div><h3>Results</h3><div>After propensity score matching, 205 and 410 patients were included in the EBVaGC and EBVnGC groups, respectively. The 3-year OS and DFS rates in the EBVaGC group were significantly higher than those in the EBVnGC group. Multivariate analysis indicated that EBER(Epstein-Barr virus-encoded small RNA) positivity was an independent protective factor for OS and DFS. Among stage II and III EBVaGC patients, those receiving ≥4 cycles of chemotherapy had a 3-year OS significantly better than those receiving <4 cycles. The RSF model based on EBER status outperformed the Cox model and TNM staging system in predicting the 3-year OS and DFS.</div></div><div><h3>Conclusion</h3><div>The prognostic prediction model established based on the EBER status has good clinical application value and can provide a new reference for clinical follow-up management. It is recommended that patients with stage II and III EBVaGC receive at least four cycles of chemotherapy postoperatively to improve survival.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109737"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ejso","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0748798325001659","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The prognosis of Epstein-Barr virus-associated gastric cancer (EBVaGC)needs to be validated by high-quality studies. This study aimed to assess the long-term survival of EBVaGC patients after radical gastrectomy using multicenter data to explore the potential value of EBV infection status as a prognostic predictor.
Methods
We analyzed the clinical data of patients with EBVaGC and Epstein-Barr virus-negative gastric cancer (EBVnGC) who underwent radical gastrectomy from January 2013 to July 2020. The Kaplan-Meier method and Cox regression analysis were used to evaluate overall survival (OS) and disease-free survival (DFS). A Random Survival Forest (RSF) model was constructed to predict the prognosis.
Results
After propensity score matching, 205 and 410 patients were included in the EBVaGC and EBVnGC groups, respectively. The 3-year OS and DFS rates in the EBVaGC group were significantly higher than those in the EBVnGC group. Multivariate analysis indicated that EBER(Epstein-Barr virus-encoded small RNA) positivity was an independent protective factor for OS and DFS. Among stage II and III EBVaGC patients, those receiving ≥4 cycles of chemotherapy had a 3-year OS significantly better than those receiving <4 cycles. The RSF model based on EBER status outperformed the Cox model and TNM staging system in predicting the 3-year OS and DFS.
Conclusion
The prognostic prediction model established based on the EBER status has good clinical application value and can provide a new reference for clinical follow-up management. It is recommended that patients with stage II and III EBVaGC receive at least four cycles of chemotherapy postoperatively to improve survival.
期刊介绍:
JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery.
The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.