Tumor index predicts recurrences of patients with pathological stage Ⅰ gastric cancer after radical surgical resection.

[BACKGROUND] Despite the favorable prognosis of patients with pathological stage I gastric cancer (GC), recurrence may occur in a subset of individuals, and the underlying risk factors are currently being investigated. Tumor index (TI) plays a valuable role in predicting the prognosis of GC. The study aimed to determine the prognostic effect of TI on stage Ⅰ GC.

[METHODS] Patients with stage Ⅰ GC who underwent radical resection were enrolled from the two medical centers from 2010 to 2020. TI was calculated by the pathological T stage multiplied by the maximum tumor diameter. The primary outcome was disease-free survival (DFS) and overall survival (OS). Cox regression analyses were utilized to evaluate the correlation between TI and prognosis.

[RESULTS] The final analysis included a total of 684 patients from two medical centers. Higher TI exhibited a significant correlation with several clinicopathologic features, including N0 stage, TNM stage ⅠB, and positive PNI (all P < 0.05). Patients with high TI showed inferior DFS and OS compared to those with a low TI (P < 0.05). Multivariate analysis revealed that TI was an independent prognostic factor for DFS (hazard ratio (HR) = 2.44, P = 0.010) and OS (HR = 2.39, P = 0.014) in patients with stage Ⅰ GC who underwent radical resection.

[CONCLUSION] TI was an independent risk factor in recurrence and overall survival for stage Ⅰ GC patients who received curative gastrectomy. Incorporation of TI into clinical decision-making regarding adjuvant therapy and intensity of follow-up may be warranted.