Gastric Cancer最新文献

{"title":"Long-term prognosis of mixed histological-type gastric cancers cured by endoscopic resection: a multicenter prospective cohort study.","authors":"Yusuke Horiuchi, Toshiaki Hirasawa, Haruhisa Suzuki, Kohei Takizawa, Yoji Takeuchi, Kenji Ishido, Shu Hoteya, Tomonori Yano, Shinji Tanaka, Yosuke Toya, Masahiro Nakagawa, Tetsuya Yoshizaki, Naohiro Yoshida, Kingo Hirasawa, Mitsuru Matsuda, Hironori Yamamoto, Shigeto Koizumi, Shinichiro Hori, Masahiro Tajika, Takuto Hikichi, Kenshi Yao, Taichi Shimazu, Hiroyuki Ono, Satoshi Tanabe, Hitoshi Kondo, Hiroyasu Iishi, Motoki Ninomiya, Ichiro Oda","doi":"10.1007/s10120-025-01651-5","DOIUrl":"https://doi.org/10.1007/s10120-025-01651-5","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is divided into differentiated and undifferentiated types and sometimes exhibits mixed histology. However, the risk of gastric cancer-related death after curative endoscopic resection for mixed histology remains unknown. This study evaluated the long-term prognosis of mixed histological type gastric cancers treated with endoscopic resection.</p><p><strong>Methods: </strong>Data from a Japanese multicenter prospective cohort study were analyzed. Patients with single gastric cancer lesions who underwent curative endoscopic resection were included and divided into those with pure or mixed histological types. Patients with both types of gastric cancer were compared in terms of 5-year overall survival and 5-year disease-specific survival related to primary gastric cancers.</p><p><strong>Results: </strong>Pure histological type was observed in 6434 patients with 6434 lesions, and mixed histological type was observed in 161 patients with 161 lesions. Overall survival was not significantly different between patients with both types (p = 0.415). The 5-year disease-specific survival was lower in patients with mixed histological type than in those with pure histological type (p = 0.003). After stratification by curative endoscopic resection criteria, in cases of pT1a/M, differentiated-type dominance, tumor size ≤ 3 cm with ulcerative findings, no lymphovascular invasion, and R0 resection, the 5-year disease-specific survival was significantly lower in patients with mixed histological type than in those with pure type (p < 0.001).</p><p><strong>Conclusions: </strong>The long-term prognosis in cured cases, including those with mixed histological type, was favorable. Stratification analysis showed that mixed histological types with ulcers were more likely to cause primary gastric cancer-related death than pure histological type and might need more careful surveillance.</p><p><strong>Clinical trial registration: </strong>UMIN Clinical Trial Registry, UMIN000005871.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early stage gastric cancer with unusual sarcomatous component and no recurrence after endoscopic submucosal dissection: a case report.","authors":"Kohei Shigeta, Yoichi Yamamoto, Tadakazu Shimoda, Takashi Sugino, Hiroyuki Ono","doi":"10.1007/s10120-025-01650-6","DOIUrl":"https://doi.org/10.1007/s10120-025-01650-6","url":null,"abstract":"<p><p>Gastric cancer with sarcomatous changes is relatively rare and often detected at an advanced stage. We report the case of an 82-year-old man with early stage gastric cancer exhibiting an unusual morphology with a polypoid growth of a sarcomatous component arising from a flat area of a well-differentiated adenocarcinoma. He achieved mid-term remission after endoscopic submucosal dissection (ESD). Upon admission, upper gastrointestinal endoscopy revealed a 60-mm flat elevated lesion with a nodule; no lymph node or distant metastasis was noted. He was diagnosed with early stage gastric cancer and underwent ESD. Pathological examination of the nodule revealed carcinomatous cells transitioning to atypical spindle cells and sarcomatous changes, suggesting that the sarcomatous component originated from a gastric-type adenocarcinoma. There was no local recurrence or metastasis at 21 months post-ESD. This is the first report of a case of early stage gastric cancer with a sarcomatous change that achieved mid-term outcome after ESD.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of homologous recombination-related gene mutations in survival outcomes of first-line nivolumab plus chemotherapy for gastric cancer.","authors":"Yuna Lee, Hyung-Don Kim, Sun Young Lee, Hyungeun Lee, Jaewon Hyung, Meesun Moon, Jinho Shin, Young Soo Park, Tae Won Kim, Min-Hee Ryu","doi":"10.1007/s10120-025-01648-0","DOIUrl":"https://doi.org/10.1007/s10120-025-01648-0","url":null,"abstract":"<p><strong>Background: </strong>Homologous recombination repair (HRR) gene mutations contribute to genomic instability. However, their clinical value in immune checkpoint inhibitor (ICI)-based treatments in gastric cancer remains unclear. Therefore, this study aims to investigate the efficacy of nivolumab plus chemotherapy according to the HRR mutation status in patients with advanced gastric cancer.</p><p><strong>Methods: </strong>This single-center study included patients with gastric cancer with available panel sequencing results who were treated with first-line nivolumab plus chemotherapy (n = 115) or chemotherapy alone (n = 172). Mutation status of 17 HRR genes (BARD1, BLM, BRCA1, BRCA2, BRIP1, MRE11A, NBN, PALB2, PARP1, POLD1, RAD50, RAD51, RAD51C, RAD51D, RAD52, RAD54L, and XRCC2) was assessed using targeted next-generation sequencing.</p><p><strong>Results: </strong>Among patients treated with nivolumab plus chemotherapy, 36.5% had HRR mutations, with BRCA2 mutation being the most common mutation (11.3%). Compared to those of the no-HRR mutation group, the HRR mutation group exhibited a higher objective response rate, longer progression-free survival (PFS) (median 12.8 vs. 6.5 months; hazard ratio HR 0.57), and overall survival (OS) (median not reached vs. 14.2 months; HR 0.40) with nivolumab plus chemotherapy. Patients with HRR mutations treated with nivolumab plus chemotherapy showed favorable PFS and OS compared to those treated with chemotherapy alone. However, this difference was not observed in patients without HRR mutations.</p><p><strong>Conclusions: </strong>HRR mutations were associated with favorable survival outcomes in patients treated with nivolumab plus chemotherapy. Our findings suggest that HRR mutations may serve as a potential predictive biomarker for first-line ICI-based chemotherapy in gastric cancer.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinicopathological features of gastric carcinoma in autoimmune gastritis with and without Helicobacter pylori infection.","authors":"Ayaka Takasu, Toshiaki Hirasawa, Yuka Higashi, Kaoru Nakano, Souya Nunobe, Takuji Gotoda, Hiroshi Kawachi","doi":"10.1007/s10120-025-01649-z","DOIUrl":"10.1007/s10120-025-01649-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic atrophic gastritis, represented by Helicobacter pylori (H. pylori) or autoimmune gastritis (AIG), has been recognized as a risk factor for gastric carcinoma (GC). Differences in the clinicopathological features of GC with AIG (GC-AIG) based on H. pylori infection status remain unclear.</p><p><strong>Methods: </strong>This retrospective analysis included 65 cases of GC-AIG in which endoscopic resection or gastrectomy was performed at a single center between 2008 and 2024. The cases were categorized into Group A (H. pylori-naïve GC-AIG) or Group B (H. pylori-infected GC-AIG), and the clinical and pathological data were compared between the groups.</p><p><strong>Results: </strong>Group A included 18 cases with 25 lesions and Group B included 47 cases with 72 lesions. The median age [interquartile range] was significantly younger in Group A (70 [63-74] years) than in Group B (75 [62-79] years, p = 0.045). Tumors in Group A were more frequently located in the upper and middle stomach, whereas those in Group B were predominantly located in the lower stomach (p = 0.006). Group A had a significantly higher proportion of pure undifferentiated-type adenocarcinoma (Laurén's diffuse type) than Group B (28.0% versus 8.3%, p = 0.027).</p><p><strong>Conclusions: </strong>H. pylori-naïve GC-AIG is characterized by younger age, a higher prevalence of pure undifferentiated-type adenocarcinoma, and tumors predominantly located in the upper and middle stomach.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing efficacy of anti-glypican-1 antibody-drug conjugate as potential therapeutic approach for gastric cancer.","authors":"Yuji Suzuki, Satoshi Serada, Masashi Yamashita, Kota Kawabata, Tsuyoshi Takahashi, Kengo Obata, Akihito Jo, Eiji Funajima, Yuichiro Doki, Tetsuji Naka","doi":"10.1007/s10120-025-01647-1","DOIUrl":"https://doi.org/10.1007/s10120-025-01647-1","url":null,"abstract":"<p><strong>Background: </strong>Despite significant advancements in cancer treatment, gastric cancer (GC) continues to have a high incidence and mortality rate. Antibody-drug conjugates (ADCs) are emerging as a viable treatment option for GC. Glypican-1 (GPC1), a cell surface proteoglycan, has garnered interest for its role in tumor growth and its potential as a biomarker. This study evaluated the efficacy of an ADC comprising a humanized anti-GPC1 monoclonal antibody conjugated with monomethyl auristatin E (GPC1-ADC) to target GPC1 in GC.</p><p><strong>Methods: </strong>GPC1 expression was assessed in GC cell lines and tissues. The cytotoxic efficacy and mechanism of action of GPC1-ADC were evaluated through comprehensive in vitro assays. In vivo efficacy was further assessed in xenograft mouse models, focusing on tumor growth inhibition and its performance against peritoneal dissemination.</p><p><strong>Results: </strong>In vitro, GPC1-ADC exhibited significant cytotoxicity against GPC1-positive cell lines by inducing cell cycle arrest and apoptosis. Additionally, GPC1-ADC demonstrated promising bystander-killing activity via cancer-associated fibroblasts, highlighting its potential to target the heterogeneous tumor microenvironment characteristic of GC. In vivo, GPC1-ADC significantly inhibited tumor growth and demonstrated substantial therapeutic effects in a peritoneal dissemination model. Immunohistochemical analysis of tumor specimens from GC patients revealed that 90.2% of differentiated types and 66.7% of poorly differentiated types exhibited high GPC1 expression. High GPC1 expression in tumor samples was significantly associated with poorer progression-free and overall survival.</p><p><strong>Conclusions: </strong>Our findings suggest that GPC1-targeting ADCs represent a promising therapeutic option for GPC1-positive GC.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent hypermethylation of CpG islands and hypomethylation of CpG-poor regions are associated with gastric cancer risk after Helicobacter pylori eradication.","authors":"Gota Sudo, Eiichiro Yamamoto, Takeshi Niinuma, Mitsunobu Saito, Hiroshi Kitajima, Kazuya Ishiguro, Akira Yorozu, Mutsumi Toyota, Hironori Aoki, Kei Mitsuhashi, Shinji Yoshii, Hiro-O Yamano, Masashi Idogawa, Reo Maruyama, Tamotsu Sugai, Hiroshi Nakase, Hiromu Suzuki","doi":"10.1007/s10120-025-01646-2","DOIUrl":"https://doi.org/10.1007/s10120-025-01646-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Aberrant DNA methylation persists in the gastric mucosa after Helicobacter pylori (H. pylori) eradication and may contribute to the development of post-eradication gastric cancer (PEGC). We aimed to comprehensively investigate both DNA hypermethylation and hypomethylation and their relevance to cancer risk.</p><p><strong>Methods: </strong>Genome-wide DNA methylation profiling was performed using Infinium MethylationEPIC BeadChips with tumor tissue and non-cancerous mucosa from PEGC patients. Public datasets, including The Cancer Genome Atlas (TCGA)-STAD and H. pylori-negative controls, were integrated to identify recurrently hyper- and hypomethylated loci. Representative gene methylation levels were validated using bisulfite pyrosequencing. Correlation analyses were conducted to link DNA methylation with gene expression.</p><p><strong>Results: </strong>Non-cancerous mucosa from PEGC patients exhibited substantial CpG island (CGI) hypermethylation. In parallel, we detected 4081 CpG sites recurrently hypomethylated in GC, many of which were also hypomethylated in non-cancerous mucosa from PEGC patients. The majority of hypomethylated sites were located outside of CGIs, often near oncogenes such as CDH17, HNF4A and CD44, and showed inverse correlations with gene expression. CGI hypermethylation and CpG hypomethylation were positively correlated across samples.</p><p><strong>Conclusions: </strong>CGI hypermethylation and non-CGI hypomethylation are tightly linked and may co-emerge during the early stages of gastric carcinogenesis. Their concurrent presence in non-cancerous mucosa from PEGC patients suggests a coordinated epigenetic landscape contributing to residual cancer risk after H. pylori eradication.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resveratrol targets mitochondrial USP36-SOD2 to induce autophagy-ferroptosis and inhibit gastric cancer progression.","authors":"Xuan Zhao, Sheng Lu, Min Yan, Zheng-Gang Zhu, Feng Dong, Chao Yan","doi":"10.1007/s10120-025-01645-3","DOIUrl":"https://doi.org/10.1007/s10120-025-01645-3","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is an aggressive malignancy with high metastatic potential, limiting effective treatments. Resveratrol, a natural polyphenol, exhibits anti-cancer properties by modulating mitochondrial function and inducing programmed cell death (PCD) pathways. However, its role in mitochondrial disruption and the regulation of deubiquitination remains unclear.</p><p><strong>Methods: </strong>Clinical samples and gastric cancer cell lines were analyzed to assess USP36 and SOD2 expression. Cells were treated with resveratrol, followed by functional assays (WB, qPCR, colony formation, Transwell migration, fluorescence staining) to evaluate its effects on USP36-mediated SOD2 stabilization, mitochondrial function, autophagy, and ferroptosis. A xenograft model was used to examine in vivo tumor growth.</p><p><strong>Results: </strong>USP36 deubiquitinates and stabilizes SOD2, thereby preserving mitochondrial integrity and facilitating tumor progression. Resveratrol disrupts this axis, reducing SOD2 stability, inducing mitochondrial dysfunction, and triggering autophagy and ferroptosis. In vitro, resveratrol significantly inhibited gastric cancer cell proliferation and migration; in vivo, it suppressed tumor growth.</p><p><strong>Conclusion: </strong>This study identifies the USP36-SOD2 axis as a critical driver of gastric cancer progression and reveals the therapeutic potential of resveratrol in targeting this pathway. By destabilizing mitochondrial function, resveratrol induces both autophagy and ferroptosis, thereby suppressing tumor progression and offering a promising strategy to improve clinical outcomes. Resveratrol inhibits USP36-mediated stabilization of SOD2, which further induces autophagy and ferroptosis by inducing mitochondrial damage and ROS accumulation, and suppressing tumor progression in a xenograft model. These findings underscore the USP36-SOD2 axis as a potential therapeutic target and highlight the adjunctive chemotherapeutic potential of resveratrol.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zolbetuximab-related gastritis: a case report of the patient with prolonged gastrointestinal symptoms.","authors":"Yuya Sugiyama, Hiroki Tanabe, Shion Tachibana, Kohei Iribe, Sayaka Yuzawa, Hiroyuki Iwaki, Yukinori Yoshida, Mikihiro Fujiya","doi":"10.1007/s10120-025-01607-9","DOIUrl":"10.1007/s10120-025-01607-9","url":null,"abstract":"<p><p>A 73-year-old male patient presented with anemia and was diagnosed with unresectable advanced gastric cancer with distant lymph node metastases. The biopsy specimen showed a poorly differentiated adenocarcinoma. Immunohistochemistry was negative for human epidermal growth factor receptor 2, positive for claudin- 18, and revealed a preserved mismatch repair status. A regimen of capecitabine, oxaliplatin, and zolbetuximab was chosen as the primary chemotherapy regimen. On day 2, the patient started complaining of nausea and decreased appetite, and his symptoms gradually worsened. Esophagogastroduodenoscopy performed on day 11 revealed an erythematous and edematous mucosa with white secretions throughout the stomach. A histopathological examination revealed epithalaxia at the surface and severe inflammatory cell infiltration in the lamina propria. These endoscopic and histological findings indicated zolbetuximab-related gastritis. His symptoms improved three weeks after the discontinuation of chemotherapy. Endoscopic and pathological improvements of the gastritis were confirmed three months after the discontinuation of zolbetuximab. This report describes the first case of prolonged severe gastrointestinal symptoms with severe gastritis caused by zolbetuximab, as demonstrated by endoscopic and histopathological evidence.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"705-711"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and application of deep learning-based diagnostics for pathologic diagnosis of gastric endoscopic submucosal dissection specimens.","authors":"Soomin Ahn, Yiyu Hong, Sujin Park, Yunjoo Cho, Inwoo Hwang, Ji Min Na, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Jae J Kim, Kyoung-Mee Kim","doi":"10.1007/s10120-025-01612-y","DOIUrl":"10.1007/s10120-025-01612-y","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of ESD specimens is crucial for managing early gastric cancer. Identifying tumor areas in serially sectioned ESD specimens requires experience and is time-consuming. This study aimed to develop and evaluate a deep learning model for diagnosing ESD specimens.</p><p><strong>Methods: </strong>Whole-slide images of 366 ESD specimens of adenocarcinoma were analyzed, with 2257 annotated regions of interest (tumor and muscularis mucosa) and 83,839 patch images. The development set was divided into training and internal validation sets. Tissue segmentation performance was evaluated using the internal validation set. A detection algorithm for tumor and submucosal invasion at the whole-slide image level was developed, and its performance was evaluated using a test set.</p><p><strong>Results: </strong>The model achieved Dice coefficients of 0.85 and 0.79 for segmentation of tumor and muscularis mucosa, respectively. In the test set, the diagnostic performance of tumor detection, measured by the AUROC, was 0.995, with a specificity of 1.000 and a sensitivity of 0.947. For detecting submucosal invasion, the model achieved an AUROC of 0.981, with a specificity of 0.956 and a sensitivity of 0.907. Pathologists' performance in diagnosing ESD specimens was evaluated with and without assistance from the deep learning model, and the model significantly reduced the mean diagnosis time (747 s without assistance vs. 478 s with assistance, P < 0.001).</p><p><strong>Conclusion: </strong>The deep learning model demonstrated satisfactory performance in tissue segmentation and high accuracy in detecting tumors and submucosal invasion. This model can potentially serve as a screening tool in the histopathological diagnosis of ESD specimens.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"609-619"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformer-based skeletal muscle deep-learning model for survival prediction in gastric cancer patients after curative resection.","authors":"Qiuying Chen, Lian Jian, Hua Xiao, Bin Zhang, Xiaoping Yu, Bo Lai, Xuewei Wu, Jingjing You, Zhe Jin, Li Yu, Shuixing Zhang","doi":"10.1007/s10120-025-01614-w","DOIUrl":"10.1007/s10120-025-01614-w","url":null,"abstract":"<p><strong>Background: </strong>We developed and evaluated a skeletal muscle deep-learning (SMDL) model using skeletal muscle computed tomography (CT) imaging to predict the survival of patients with gastric cancer (GC).</p><p><strong>Methods: </strong>This multicenter retrospective study included patients who underwent curative resection of GC between April 2008 and December 2020. Preoperative CT images at the third lumbar vertebra were used to develop a Transformer-based SMDL model for predicting recurrence-free survival (RFS) and disease-specific survival (DSS). The predictive performance of the SMDL model was assessed using the area under the curve (AUC) and benchmarked against both alternative artificial intelligence models and conventional body composition parameters. The association between the model score and survival was assessed using Cox regression analysis. An integrated model combining SMDL signature with clinical variables was constructed, and its discrimination and fairness were evaluated.</p><p><strong>Results: </strong>A total of 1242, 311, and 94 patients were assigned to the training, internal, and external validation cohorts, respectively. The Transformer-based SMDL model yielded AUCs of 0.791-0.943 for predicting RFS and DSS across all three cohorts and significantly outperformed other models and body composition parameters. The model score was a strong independent prognostic factor for survival. Incorporating the SMDL signature into the clinical model resulted in better prognostic prediction performance. The false-negative and false-positive rates of the integrated model were similar across sex and age subgroups, indicating robust fairness.</p><p><strong>Conclusions: </strong>The Transformer-based SMDL model could accurately predict survival of GC and identify patients at high risk of recurrence or death, thereby assisting clinical decision-making.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"684-695"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}