Immunoscore and Post-Neoadjuvant Pathological Features in Microsatellite-Stable Locally Advanced Gastric Cancer: A Retrospective Cohort Study

Abstract

Simple Summary Patients with locally advanced gastric cancer can have markedly different outcomes even when they receive similar treatments and have comparable disease stages. This highlights the need for additional markers that better reflect tumor biology and help identify patients at higher risk of recurrence. The Immunoscore measures the immune response within and around the tumor by assessing specific types of tumor-infiltrating immune cells. In this study, we evaluated the Immunoscore in surgical specimens from patients with microsatellite-stable locally advanced gastric cancer who had received chemotherapy before surgery. A higher Immunoscore was associated with less advanced residual tumor and nodal disease and less frequent perineural invasion, but it was not significantly associated with conventional tumor regression grade. Although patients with higher Immunoscores had numerically longer disease-free survival, this association was not statistically significant in the primary survival analysis. These findings suggest that the Immunoscore may complement conventional pathological assessment and warrant further investigation as a potential marker for postoperative risk stratification after neoadjuvant treatment.