[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-372721-105":59,"doc-detail-372721-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","modified-recist-submodels-and-ordinal-regression-model-predict-neoadjuvant-chemoimmunotherapy-response-in-locally-advanced-gastric-cancer","Modified RECIST submodels and ordinal regression model predict neoadjuvant chemoimmunotherapy response in locally advanced gastric cancer","","This prospective multicenter study assessed predictive models integrating computed tomography (CT) and ultrasound (US) to estimate neoadjuvant therapy response in locally advanced gastric cancer (LAGC). Using pathological tumor regression grade (TRG) as the reference (n=75), five RECIST 1.1-derived submodels (RECIST_Expansion, UC_RECIST, CT_RECIST, V-RECIST, U-RECIST) and an ordinal regression-based nomogram were developed. V-RECIST showed the best discrimination and calibration for TRG groupings, while U-RECIST supported radiation-free, cost-effective preliminary assessment.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/modified-recist-submodels-and-ordinal-regression-model-predict-neoadjuvant-chemoimmunotherapy-response-in-locally-advanced-gastric-cancer/372721/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/modified-recist-submodels-and-ordinal-regression-model-predict-neoadjuvant-chemoimmunotherapy-response-in-locally-advanced-gastric-cancer/372721.png","ImageObject",300,407,{"name":92,"@type":93},"Ben ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What reference standard was used to evaluate the predictive models?","Question",{"text":112,"@type":113},"Pathological tumor regression grade (TRG) was used as the reference standard to assess neoadjuvant response.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which model showed the highest diagnostic performance?",{"text":117,"@type":113},"V-RECIST demonstrated the highest performance, with strong AUC and sensitivity/specificity values for TRG discrimination and classification.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is U-RECIST considered useful for clinical screening?",{"text":121,"@type":113},"U-RECIST relies on ultrasound only, providing radiation-free assessment with good diagnostic accuracy and improved cost-effectiveness for preliminary evaluation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},372721,1790282250,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","[www. nature.com/scientificreports](www. nature.com/scientificreports)  \nOPEN  \nModified RECIST submodels and ordinal regression  \nmodel predict neoadjuvant chemoimmunotherapy response in locally advanced gastric cancer  \nShu Chen, Shenghong Wei, Zaisheng Ye, Cheng Wei, Sheng Liu, Yi Wang, Yi Zeng, Jinhu Chen, Xiaopeng Wang, Jianping Jiang, Xiaoling Chen & LuchuanChen􀀍  \nThis study evaluated predictive models integrating Computed Tomography(CT) and ultrasound(US) to assess neoadjuvant therapy response in locally advanced gastric cancer (LAGC). A prospective multicenter trial (n = 75) developed five RECIST 1.1-derived submodels (RECIST_Expansion, UC_RECIST, CT_RECIST, V-RECIST, U-RECIST) and an ordinal regression-based nomogram, using pathological tumor regression grade (TRG) as the reference standard. The geometric approximation model V-RECIST exhibited superior diagnostic performance forTRG 0–2 vs. 3 discrimination (area under the curve [AUC] = 0.951, sensitivity 96.8%/specificity 80.1%) and TRG 0–1 vs. 2–3 classification (AUC = 0.868, sensitivity 85.7%/specificity 80.0%), validated by calibration curves and decision curve analysis. The US-only U-RECIST demonstrated good diagnostic accuracy (AUC = 0.906/0.811), suitable for preliminary assessment due to its safety and cost-effectiveness. The remaining models—RECIST_Expansion (lymph node evaluation only), UC_RECIST (CT-US combined protocol with gastric lesions as measurable targets), and CT_RECIST (CT-only for no-US settings)—also showed satisfactory accuracy. The ordinal regression model achieved slightly higher AUC values (0.952/0.870) and cross-validation accuracy (0.73) compared to modified RECIST models. These findings highlight the clinical utility of revised RECIST 1.1 models across diverse scenarios, with V-RECIST demonstrating the highest performance, U-RECIST offering radiation-free assessment and cost-effectiveness, and the ordinal model enhancing visualization while preserving diagnostic superiority.  \nKeywords Local advanced gastric cancer (LAGC), Neo-adjuvant therapy, Chemoimmunotherapy, RECIST, Color doppler ultrasound; nomogram model  \nGastric cancer (GC) remains a major global health burden, ranking sixth in incidence and third in mortality1. In 2020, 1.089 million new cases and 769,000 deaths were reported globally2 with China contributing 43.94% of global incidence (478,508 cases)3. GC prognosis is stage-dependent, with 5-year survival rates between 20% and 40% globally. For locally advanced gastric cancer (LAGC), this drops below 30%, necessitating surgery-centered comprehensive treatment4. Neoadjuvant chemotherapy (NAC) is now the global standard for LAGC, supported by trials like Germany’s FLOT4-AIO5 and Asia’s RESOLVE6. The Orient-16 trial7 established PD-1 inhibitorbased immunotherapy combined with chemotherapy as a first-line option for unresectable locally advanced, recurrent, or metastatic gastric/gastroesophageal junction (GEJ) adenocarcinoma.  \nHowever, standardized methods for evaluating neoadjuvant therapy efficacy remain limited. The international community primarily uses WHO criteria8 and RECIST 1.19. WHO criteria assess response via the product of longest tumor diameter and its perpendicular counterpart, while RECIST 1.1 defines target lesions and evaluates changes in total diameters from baseline10. Because the stomach is non-solid, primary gastric lesions are classified as non-measurable under RECIST, with lymph nodes ≥ 1.5 cm in short axis considered measurable11. This limitation hinders preoperative assessments, delaying precision medicine and optimal surgical timing.  \nDepartment of Gastric Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital， NHC Key Laboratory of Cancer Metabolism, No 420 Fuma Road, Jin’an District, Fuzhou 350000, Fujian Province, China.  \n􀀍 email: [sheeook@163.com](sheeook@163.com)  \n[www. nature.com/scientificreports/](www. nature.com/scientificreports/)  \nTo address this, researchers","cbCaiuwyXhylv66j","https://ap.wps.com/l/cbCaiuwyXhylv66j","pdf",1876808,12,"English","# Materials and Methods\n## Data collection\n## Inclusion criteria\n## Exclusion criteria","[{\"question\":\"What reference standard was used to evaluate the predictive models?\",\"answer\":\"Pathological tumor regression grade (TRG) was used as the reference standard to assess neoadjuvant response.\"},{\"question\":\"Which model showed the highest diagnostic performance?\",\"answer\":\"V-RECIST demonstrated the highest performance, with strong AUC and sensitivity/specificity values for TRG discrimination and classification.\"},{\"question\":\"Why is U-RECIST considered useful for clinical screening?\",\"answer\":\"U-RECIST relies on ultrasound only, providing radiation-free assessment with good diagnostic accuracy and improved cost-effectiveness for preliminary evaluation.\"}]","Modified RECIST submodels and ordinal regression model predict neoadjuvant chemoimmunotherapy response in locally advanced gastric cancer | PDF",1790195216]