Pretreatment multiphasic contrast-enhanced CT predicts tumor regression grade and survival in locally advanced gastric cancer.
2/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
116 patients with cT2-4NxM0 gastric adenocarcinoma treated with NAC treatment followed by gastrectomy between January 2019 and December 2024.
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSION] Pretreatment CECT-derived quantitative features can predict TRG response in LAGC, and a combined clinical-imaging model improves predictive performance. Higher normalized enhancement rates in the venous and delayed phases are associated with poorer overall survival, supporting pre-treatment risk stratification in clinical practice.
OpenAlex 토픽 ·
Gastric Cancer Management and Outcomes
Esophageal Cancer Research and Treatment
Gastrointestinal Tumor Research and Treatment
[OBJECTIVES] Reliable pretreatment prediction of pathological response remains a major challenge in locally advanced gastric cancer (LAGC).
- p-value P = 0.003
- p-value P = 0.007
- 95% CI 2.134-36.358
- OR 8.809
- HR 1.01
APA
Youqiang Hu, Mengli Xia, et al. (2026). Pretreatment multiphasic contrast-enhanced CT predicts tumor regression grade and survival in locally advanced gastric cancer.. Abdominal radiology (New York). https://doi.org/10.1007/s00261-026-05523-z
MLA
Youqiang Hu, et al.. "Pretreatment multiphasic contrast-enhanced CT predicts tumor regression grade and survival in locally advanced gastric cancer.." Abdominal radiology (New York), 2026.
PMID
42008173
Abstract
[OBJECTIVES] Reliable pretreatment prediction of pathological response remains a major challenge in locally advanced gastric cancer (LAGC). This study evaluated whether quantitative parameters from multiphasic contrast-enhanced CT (CECT) can predict tumor regression grade (TRG) after neoadjuvant chemotherapy (NAC) and provide prognostic information.
[METHODS] We retrospectively analyzed 116 patients with cT2-4NxM0 gastric adenocarcinoma treated with NAC treatment followed by gastrectomy between January 2019 and December 2024. Quantitative imaging variables included phase-specific tumor attenuation ([Formula: see text], normalized enhancement difference ([Formula: see text]), normalized enhancement rate ([Formula: see text]), tumor area, and enhancement pattern. TRG was assessed on surgical specimens using the Mandard system; responders were defined as TRG 1-2 and non-responders as TRG 3-5. Candidate variables were screened by univariate analysis and Spearman correlation, then enrolled into weighted multivariable logistic regression with 5-fold cross-validation. Associations with overall survival were evaluated using univariate Cox and Kaplan-Meier analyses.
[RESULTS] Forty-one patients were responders and 75 were non-responders. CA199, CEA, and age were independent clinical predictors. Among imaging features, venous-phase tumor attenuation ([Formula: see text]; OR = 8.809, 95% CI: 2.134-36.358, P = 0.003) and arterial-phase normalized enhancement rate ([Formula: see text]; OR = 3.200, 95% CI: 1.365-7.504, P = 0.007) independently predicted TRG response. The clinical, imaging, and combined models achieved mean AUCs of 0.746, 0.807, and 0.869, respectively; the combined model showed the best overall discrimination (accuracy 0.759, sensitivity 0.703, specificity 0.787) with good calibration. Higher [Formula: see text] (HR = 1.01, P = 0.004) and [Formula: see text] (HR = 1.01, P = 0.043) were associated with worse overall survival.
[CONCLUSION] Pretreatment CECT-derived quantitative features can predict TRG response in LAGC, and a combined clinical-imaging model improves predictive performance. Higher normalized enhancement rates in the venous and delayed phases are associated with poorer overall survival, supporting pre-treatment risk stratification in clinical practice.
[METHODS] We retrospectively analyzed 116 patients with cT2-4NxM0 gastric adenocarcinoma treated with NAC treatment followed by gastrectomy between January 2019 and December 2024. Quantitative imaging variables included phase-specific tumor attenuation ([Formula: see text], normalized enhancement difference ([Formula: see text]), normalized enhancement rate ([Formula: see text]), tumor area, and enhancement pattern. TRG was assessed on surgical specimens using the Mandard system; responders were defined as TRG 1-2 and non-responders as TRG 3-5. Candidate variables were screened by univariate analysis and Spearman correlation, then enrolled into weighted multivariable logistic regression with 5-fold cross-validation. Associations with overall survival were evaluated using univariate Cox and Kaplan-Meier analyses.
[RESULTS] Forty-one patients were responders and 75 were non-responders. CA199, CEA, and age were independent clinical predictors. Among imaging features, venous-phase tumor attenuation ([Formula: see text]; OR = 8.809, 95% CI: 2.134-36.358, P = 0.003) and arterial-phase normalized enhancement rate ([Formula: see text]; OR = 3.200, 95% CI: 1.365-7.504, P = 0.007) independently predicted TRG response. The clinical, imaging, and combined models achieved mean AUCs of 0.746, 0.807, and 0.869, respectively; the combined model showed the best overall discrimination (accuracy 0.759, sensitivity 0.703, specificity 0.787) with good calibration. Higher [Formula: see text] (HR = 1.01, P = 0.004) and [Formula: see text] (HR = 1.01, P = 0.043) were associated with worse overall survival.
[CONCLUSION] Pretreatment CECT-derived quantitative features can predict TRG response in LAGC, and a combined clinical-imaging model improves predictive performance. Higher normalized enhancement rates in the venous and delayed phases are associated with poorer overall survival, supporting pre-treatment risk stratification in clinical practice.
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