ArticleEuropean radiology2025
CT radiomics-based intratumoral and intertumoral heterogeneity indicators for prognosis prediction in gastric cancer patients receiving neoadjuvant chemotherapy.
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed.
- Spectral CT-based habitat analysis for predicting pathologic response to neoadjuvant therapy in gastric cancer.European radiology · 2026Article
- CT-based Intratumoral Heterogeneity Score for Preoperative Prediction of Lymphovascular Invasion and Prognosis in Lung Adenocarcinoma: A Multicenter Validation and Radiogenomic Interpretation.Annals of surgical oncology · 2026Article
- Discordance in tumour response assessment for gastric cancer after neoadjuvant chemotherapy using different methods.Abdominal radiology (New York) · 2026Article
- Development and Validation of Time-to-Event Machine Learning Models for Predicting Disease-Free Survival in Patients with Locally Advanced Colorectal Cancer: A Multicenter Cohort Study.Annals of surgical oncology · 2026Article
- Topologically distinct 2D and 3D intratumoral heterogeneity scores for preoperatively predicting invasiveness in stage I lung adenocarcinoma: A multicenter study.PLOS digital health · 2026Article
- Article
- 3D intratumoral heterogeneity-based quantitative score from chest CT for preoperative prediction of visceral pleural invasion in lung adenocarcinoma: a multicenter study.Frontiers in oncology · 2026Article
- Computed tomography 3D reconstruction and texture analysis for evaluating the efficacy of neoadjuvant chemotherapy in advanced gastric cancer.World journal of gastrointestinal surgery · 2025Article
- Preoperative CT-based radiomics nomogram for progression-free survival prediction in pediatric posterior mediastinal malignancies.Frontiers in oncology · 2025Article
- Stacking Model-Based Preoperative Prediction of Lymphovascular Invasion in Lung Adenocarcinoma by Integrating Intratumoral Heterogeneity Score and Clinicoradiological Features: A Multicenter Study.Technology in cancer research & treatmentArticle
- Decoding Intratumoral Heterogeneity in Breast Cancer: The Evolution From Radiomics to Topological Quantification for Predicting Lymphovascular Invasion.Cancer control : journal of the Moffitt Cancer CenterReview
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Abstract
objectivesCT-based intratumoral and intertumoral heterogeneity indicators were integrated to develop a prognostic model for locally advanced gastric cancer (LAGC) patients undergoing neoadjuvant chemotherapy (NACT).
methodsThis retrospective study included 568 LAGC patients treated with NACT from two hospitals. The intratumor heterogeneity score (ITHscore) was developed to quantify the intratumoral heterogeneity of LAGCs on CT; intertumoral heterogeneity was characterized by combining the primary tumor (PT) and lymph node (LN) sizes on CT. CT indicators were measured on baseline and posttreatment CT scans; the reduction rates (%Δ) were calculated. The overall survival (OS) of all patients was recorded. Cox regression analysis was used to construct a preoperative survival prediction model (Pre-SPM) based on the baseline indicators and %Δ indicators. The predictive performance of Pre-SPM for OS was assessed. The clinicopathological data, including the ypTNM stage, were also collected to evaluate their impact on OS.
resultsPatients with lower baseline ITHscore had better prognoses (p < 0.001). Approximately 13.01% of patients exhibited contradictory changes in PT and LN sizes. Cox regression analysis selected the baseline ITHscore, baseline PT area, %ΔPT, and %ΔLN to establish the Pre-SPM. In the external validation cohort, the c-index of Pre-SPM for predicting OS was 0.72, while the AUC for predicting 5-year OS was 0.73. After adjusting for the influence of clinicopathological features, including the ypTNM stage, Pre-SPM remained an independent prognostic factor.
conclusionThe Pre-SPM model, combining intratumoral heterogeneity and intertumoral heterogeneity, has the potential to predict the OS of LAGC patients receiving NACT. KEY POINTS: Question Increased tumor heterogeneity in LAGC affects prognosis, but effective non-invasive CT methods for assessing intratumoral and intertumoral heterogeneity are lacking. Findings ITHscore indicates intratumoral heterogeneity, while changes in PT and LN sizes reflect intertumoral heterogeneity. The Pre-SPM model, integrating both, independently predicts patient outcomes. Clinical relevance Pre-SPM enhances prognosis prediction by quantifying intratumoral and intertumoral heterogeneity, potentially guiding more personalized and effective treatment strategies for patients with LAGC.
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