Comparison of tumor regression grading systems for locally advanced gastric adenocarcinoma after neoadjuvant chemotherapy

Table 3 Univariate analyses for overall survival and progression-free survival using a Cox proportional hazards model

Variables	OS		DFS
	HR (95%CI)	P value	HR (95%CI)	P value
Age
≤ 65
> 65	1.12 (0.84-1.51)	0.439	1.12 (0.84-1.49)	0.4351
BMI
≤ 23.9	1.39 (1.04-1.87)	0.027	1.31 (0.98-1.74)	0.065
> 23.9
Gender
Male
Female	1.14 (0.84-1.56)	0.393	1.06 (0.78-1.45)	0.690
ASA score
1-2
3	1.00 (0.67-1.49)	0.993	0.97 (0.65-1.43)	0.874
ECOG
0
1-2	1.29 (0.98-1.70)	0.073	1.30 (0.99-1.71)	0.056
Location
Diffuse vs Upper	3.32 (2.07-5.31)	< 0.001	2.97 (1.86-4.73)	< 0.001
Diffuse vs Middle	2.63 (1.51-4.56)	< 0.001	2.28 (1.32-3.94)	0.003
Diffuse vs Lower	3.94 (2.45-6.35)	< 0.001	3.52 (2.19-5.65)	< 0.001
Diffuse	1.00		1.00
Diameter (cm)
≤ 5
> 5	2.79 (2.00-3.88)	< 0.001	2.99 (2.17-4.13)	< 0.001
Differentiation
Well-Moderate
Poor	1.43 (1.08-1.90)	0.012	1.51 (1.15-1.99)	0.003
Histology
Non-mucinous
Mucinous or signet cell	1.86 (1.39-2.53)	< 0.001	1.77 (1.31-2.40)	< 0.001
Lymphovascular invasion
No
Yes	2.75 (2.08-3.64)	< 0.001	2.91 (2.21-3.83)	< 0.001
ypT
ypT0-2
ypT3-4	3.54 (2.35-5.36)	< 0.001	3.66 (2.44-5.49)	< 0.001
ypN
ypN0
ypN+	3.50 (2.50-4.90)	< 0.001	3.59 (2.58-4.98)	< 0.001
Resection type
Subtotal
Total	1.79 (1.35-2.36)	< 0.001	1.74 (1.32-2.28)	< 0.001
Cycle of NACT
≤ 2
> 2	1.18 (0.89-1.56)	0.247	1.18 (0.90-1.55)	0.233
NACT regimen
Platin-based	1.00		1.00
Paclitaxel-based	1.10 (0.62-1.92)	0.752	1.27 (0.75-2.15)	0.373
Triplet drug	1.05 (0.59-1.89)	0.862	1.03 (0.57-1.84)	0.930
Adjuvant chemotherapy
Received
Not received	1.36 (1.00-1.85)	0.050	1.18 (0.87-1.60)	0.286
Complications
Clavien-dindo 0-2
Clavien-dindo 3-4	1.15 (0.78-1.69)	0.491	1.11 (0.76-1.63)	0.585
JGCA2017-TRG
Grade 3 (no residual)	1.00		1.00
Grade 2b (< 10%)	8.97 (2.06-39.02)	0.003	8.75 (2.01-38.09)	0.004
Grade 2a (10%-33%)	13.55 (3.11-58.93)	0.001	14.03 (3.23-61.06)	< 0.001
Grade 1b (34%-66%)	12.83 (3.10-53.18)	< 0.001	14.05 (3.40-58.09)	< 0.001
Grade 1a (67%-99%)	15.15 (3.74-61.42)	< 0.001	15.55 (3.84-62.97)	< 0.001
Grade 0 (no response)	20.24 (4.67-87.68)	< 0.001	21.15 (4.88-91.67)	< 0.001
JGCA-TRG
Grade 3 (no residual)	1.00		1.00
Grade 2 (< 33%)	10.79 (2.59-45.05)	0.001	10.79 (2.58-45.05)	0.001
Grade 1b (34%-66%)	12.83 (3.10-53.18)	< 0.001	14.04 (3.40-58.05)	< 0.001
Grade 1a (67%-99%)	15.15 (3.74-61.42)	< 0.001	15.54 (3.84-62.93)	< 0.001
Grade 0 (no response)	20.24 (4.67-87.66)	< 0.001	21.18 (4.89-91.78)	< 0.001
Becker-TRG
1a (no residual)	1.00		1.00
1b (< 10%)	8.98 (2.06-39.06)	0.003	8.74 (2.01-38.05)	0.004
2 (10%-50%)	12.19 (2.92-50.87)	0.001	12.72 (3.05-53.06)	< 0.001
3 (> 50%)	15.50 (3.84-62.62)	< 0.001	16.15 (4.00-65.22)	< 0.001
AJCC-TRG
0 (complete response)	1.00		1.00
1 (moderate response)	10.46 (2.46-44.48)	0.001	10.31 (2.42-43.90)	0.002
2 (minimal response)	11.21 (2.71-46.34)	0.001	11.67 (2.83-48.22)	0.001
3 (poor response)	16.31 (4.03-65.97)	< 0.001	16.94 (4.19-68.49)	< 0.001
Mandard-TRG
1 (complete response)	1.00		1.00
2 (Fibrosis + scattered tumor cells)	10.46 (2.46-44.48)	0.001	10.33 (2.43-43.95)	0.002
3 (Fibrosis predominance + tumor cells)	11.20 (2.71-46.30)	0.001	11.66 (2.82-48.16)	0.001
4 (Tumor cells preponderance + fibrosis)	15.85 (3.91-64.19)	< 0.001	16.48 (4.07-66.71)	< 0.001
5 (No response)	20.27 (4.68-87.81)	< 0.001	21.22 (4.90-91.96)	< 0.001

BMI: Body mass index; ASA: American Society of Anesthesiologists; ECOG: Eastern Cooperative Oncology Group; NACT: Neoadjuvant chemotherapy; TRG: Tumor regression grade; HR: Hazard ratio; DFS: Disease-free survival; OS: Overall survival.