Stage-specific overall survival with complete five-year follow-up after D2 gastrectomy for gastric cancer at a referral hospital in Shanghai, China: a reference for comparing hospitals
- 1Department of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Gast
Abstract
BackgroundComparing long-term outcomes of gastric cancer surgery between hospitals requires a common reference. Risk-adjusted benchmarks depend on the model and population used to build them and are difficult for another hospital to reproduce. TNM stage is a prognostic classification already recorded for every resected gastric cancer. We report unadjusted stage-specific overall survival from a consecutive cohort with complete follow-up as reference data and propose a minimal dataset for producing comparable figures elsewhere.
MethodsThe cohort comprised 690 consecutive eligible patients who underwent curative-intent D2 gastrectomy for stage I to III adenocarcinoma at Ruijin Hospital, Shanghai, in 2019. All operations were performed by eight experienced, high-volume consultant surgeons. Stage followed the AJCC 8th edition: pTNM after upfront surgery (n = 570) and ypTNM after neoadjuvant chemotherapy (n = 120). Overall survival was estimated by the Kaplan-Meier method without adjustment.
ResultsThere were 199 deaths, 181 within five years. Every survivor was followed for at least 68.1 months. After upfront surgery, five-year overall survival was 95.0% (95% CI 91.4 to 97.1) for stage I, 83.8% (76.5 to 89.0) for stage II and 56.5% (49.2 to 63.1) for stage III, and was 95.0% in IA and 95.2% in IB, falling to 26.7% in IIIC. After neoadjuvant chemotherapy, five-year survival was 78.6%, 61.9% and 31.3% for ypStage I, II and III. Pooling pTNM and ypTNM lowered stage III five-year survival to 50.2%. The proposed minimal dataset has 16 items, 13 of them recorded during the admission for gastrectomy.
ConclusionsThese figures are intended as a reference for comparing hospitals rather than as a standard of care. We propose 16 items, most of them routinely recorded, from which another hospital can produce the same table and compare its results by stage.
Related
- Protocol of the PANEM trial: A randomized, phase III, parallel-arm, placebo-controlled, double-blind, multi-center superiority trial comparing PANcreatic EnzyMes versus placebo in adults after gastrectomy
- Defining a subgroup within autism leads to potential enrichment criteria in investigational therapeutic development: Comparing resting state gamma band power to a fragile X syndrome reference sample
- Five-year survival following endoscopic submucosal dissection and gastrectomy in older early gastric cancer patients in the U.S.
- Prognostic Model for Survival After Upfront R0 Gastrectomy in Peritoneal Oligometastatic Gastric Cancer.
- Comparing the upregulations of helper T cell-specific activation-induced cell markers (AIM) among COVID-19 vaccinees in Bangladesh
BibTeX
@misc{sah2026stagespecific,
title = {{Stage-specific overall survival with complete five-year follow-up after D2 gastrectomy for gastric cancer at a referral hospital in Shanghai, China: a reference for comparing hospitals}},
author = {B. K. Sah and D. Gu and J. Li and E. Chen},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.12.26365370},
url = {https://www.medrxiv.org/content/10.64898/2026.10.12.26365370v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Stage-specific overall survival with complete five-year follow-up after D2 gastrectomy for gastric cancer at a referral hospital in Shanghai, China: a reference for comparing hospitals
AU - B. K. Sah
AU - D. Gu
AU - J. Li
AU - E. Chen
PY - 2026
DA - 2026/10/12
PB - medRxiv
DO - 10.64898/2026.10.12.26365370
UR - https://www.medrxiv.org/content/10.64898/2026.10.12.26365370v1
AB - BackgroundComparing long-term outcomes of gastric cancer surgery between hospitals requires a common reference. Risk-adjusted benchmarks depend on the model and population used to build them and are difficult for another hospital to reproduce. TNM stage is a prognostic classification already recorded for every resected gastric cancer. We report unadjusted stage-specific overall survival from a consecutive cohort with complete follow-up as reference data and propose a minimal dataset for producing comparable figures elsewhere. MethodsThe cohort comprised 690 consecutive eligible patients who underwent curative-intent D2 gastrectomy for stage I to III adenocarcinoma at Ruijin Hospital, Shanghai, in 2019. All operations were performed by eight experienced, high-volume consultant surgeons. Stage followed the AJCC 8th edition: pTNM after upfront surgery (n = 570) and ypTNM after neoadjuvant chemotherapy (n = 120). Overall survival was estimated by the Kaplan-Meier method without adjustment. ResultsThere were 199 deaths, 181 within five years. Every survivor was followed for at least 68.1 months. After upfront surgery, five-year overall survival was 95.0% (95% CI 91.4 to 97.1) for stage I, 83.8% (76.5 to 89.0) for stage II and 56.5% (49.2 to 63.1) for stage III, and was 95.0% in IA and 95.2% in IB, falling to 26.7% in IIIC. After neoadjuvant chemotherapy, five-year survival was 78.6%, 61.9% and 31.3% for ypStage I, II and III. Pooling pTNM and ypTNM lowered stage III five-year survival to 50.2%. The proposed minimal dataset has 16 items, 13 of them recorded during the admission for gastrectomy. ConclusionsThese figures are intended as a reference for comparing hospitals rather than as a standard of care. We propose 16 items, most of them routinely recorded, from which another hospital can produce the same table and compare its results by stage.
ER -