Prognostic Assessment and Staging in Gastric Cancer

Gastric cancer remains a leading cause of cancer mortality worldwide, with prognosis closely tied to accurate assessment of tumour extent and nodal involvement. The cornerstone of clinical staging is the TNM system, which stratifies patients by primary tumour depth, regional lymph node metastases and distant spread. However, heterogeneity in lymphadenectomy practices and variations in tumour biology have prompted the development of refined metrics, including lymph node ratio and log-odds models, to supplement traditional staging. Beyond anatomical classification, prognostic assessment now integrates molecular markers, tumour microenvironment characteristics and advanced imaging features. This multiparametric approach aims to improve patient stratification for neoadjuvant and adjuvant therapies, guide surgical decision-making and enhance prediction of long-term survival. Emerging machine-learning techniques applied to radiomics data further extend the ability to non-invasively phenotype tumours, while nomograms combining clinical, pathological and biomolecular variables offer personalised risk estimates. Collectively, these advances underscore a shift towards more nuanced and patient-centred prognostic frameworks.

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Prognostic Assessment and Staging in Gastric Cancer publication trend

The graph below shows the total number of articles in prognostic assessment and staging in gastric cancer across all publications each year (not limited to Nature Index journals).

Technical terms

TNM staging system: A framework categorising cancer by the size and extent of the primary Tumour (T), involvement of regional lymph Nodes (N) and presence of distant Metastasis (M).
Log odds of positive lymph nodes (LODDS): The logarithm of the ratio between the number of positive and negative lymph nodes, providing a continuous measure of nodal burden.
Positive lymph node ratio (PLNR): The proportion of metastatic lymph nodes relative to the total number examined, used to refine prognostic stratification.
Radiomics: Quantitative extraction of high-dimensional data from medical imaging modalities to characterise tumour phenotype and predict clinical outcomes.

References

1. Prognostic significance of an innovative staging system based on the logarithmic odds of positive lymph nodes for resectable gastroesophageal cancer after neoadjuvant chemoradiation: a population-based study with external validation of data. Journal of Translational Medicine (2024).
2. A Comprehensive Review of Prognostic Factors in Patients with Gastric Adenocarcinoma. Cancers (2023).
3. Positive Lymph Node Ratio as a new prognostic score in Geriatric patients with operated gastric cancer. Heliyon (2024).
4. A Neoteric Feature Extraction Technique to Predict the Survival of Gastric Cancer Patients. Diagnostics (2024).