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

Table 4 Multivariate Cox hazards regression model for the predictable risk of overall survival and disease-free survival in different covariate inclusion in whole patients

	Whole patients (n = 413)
Covariates	OS		DFS
	HR	P value	HR	P value
BMI ≤ 23.9	1.37 (1.01-1.87)	0.045	1.28 (0.95-1.72)	0.109
ECOG > 0	1.19 (0.87-1.61)	0.271	1.18 (0.88-1.60)	0.272
Linitis plastica	1.74 (0.97-3.13)	0.063	1.30 (0.74-2.30)	0.362
Diameter > 5 cm	1.20 (0.77-1.88)	0.426	1.43 (0.93-2.19)	0.102
Poorly differentiated	1.16 (0.85-1.57)	0.345	1.24 (0.92-1.66)	0.160
Mucinous or signet cell	1.45 (1.03-2.05)	0.036	1.32 (0.94-1.84)	0.111
Lymphovascular invasion	1.53 (1.12-2.10)	0.008	1.61 (1.18-2.19)	0.002
ypT3-4	1.45 (0.92-2.28)	0.113	1.52 (0.97-2.37)	0.065
ypN+	1.96 (1.35-2.85)	< 0.001	1.94 (1.34-2.82)	< 0.001
Total gastrectomy	1.30 (0.94-1.79)	0.118	1.23 (0.90-1.69)	0.202
Without AC	1.35 (0.98-1.87)	0.066	Not included	NA
JGCA2017-TRG (Model 1)
Grade 3 (no residual)	1.00		1.00
Grade 2b (< 10%)	4.69 (1.04-21.08)	0.044	4.50 (1.00-20.27)	0.050
Grade 2a (10%-33%)	5.48 (1.19-25.23)	0.029	5.50 (1.20-25.26)	0.028
Grade 1b (34%-66%)	5.32 (1.22-23.30)	0.026	5.73 (1.32-24.88)	0.020
Grade 1a (67%-99%)	6.69 (1.55-28.96)	0.011	6.22 (1.44-26.81)	0.014
Grade 0 (no response)	8.60 (1.87-39.58)	0.006	8.44 (1.84-38.76)	0.006
JGCA-TRG (Model 2)
Grade 3 (no residual)	1.00
Grade 2 (< 33%)	5.00 (1.15-21.78)	0.032	4.90 (1.13-21.30)	0.034
Grade 1b (34%-66%)	5.27 (1.21-23.05)	0.027	5.67 (1.30-24.61)	0.021
Grade 1a (67%-99%)	6.63 (1.53-28.66)	0.011	6.16 (1.43-26.52)	0.015
Grade 0 (no response)	8.48 (1.84-39.00)	0.006	8.31 (1.81-38.15)	0.006
Becker-TRG (Model 3)
1a (no residual)	1.00		1.00
1b (< 10%)	4.74 (1.05-21.30)	0.043	4.57 (1.02-20.57)	0.047
2 (10%-50%)	5.11 (1.16-22.51)	0.031	5.13 (1.17-22.49)	0.030
3 (> 50%)	6.77 (1.57-29.14)	0.010	6.64 (1.55-28.46)	0.011
AJCC-TRG (Model 4)
0 (complete response)	1.00		1.00
1 (moderate response)	5.39 (1.22-23.78)	0.026	5.34 (1.21-23.50)	0.027
2 (minimal response)	5.01 (1.15-21.85)	0.032	5.05 (1.16-21.93)	0.031
3 (poor response)	6.72 (1.56-28.97)	0.011	6.53 (1.52-28.05)	0.012
Mandard-TRG (Model 5)
1 (complete response)	1.00		1.00
2 (Fibrosis + scattered tumor cells)	5.37 (1.22-23.68)	0.026	5.31 (1.21-23.39)	0.027
3 (Fibrosis predominance + tumor cells)	4.95 (1.14-21.60)	0.033	4.98 (1.15-21.62)	0.032
4 (Tumor cells preponderance + fibrosis)	6.44 (1.49-27.87)	0.013	6.26 (1.45-26.93)	0.014
5 (No response)	8.44 (1.83-38.86)	0.006	8.41 (1.83-38.60)	0.006

BMI: Body mass index; ECOG: Eastern Cooperative Oncology Group; AC: Adjuvant chemotherapy; TRG: Tumor regression grade; HR: Hazard ratio; DFS: Disease-free survival; OS: Overall survival.