title: Association of HER2 status with prognosis in gastric cancer patients undergoing R0 resection: A large-scale multicenter study in China.
abstract: OBJECTIVE
  To determine whether the positive status of human epidermal growth receptor 2 (HER2) can be regarded as an effective prognostic factor for patients with gastric cancer (GC) undergoing R0 resection.
  
  
  METHODS
  A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical (IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-node-metastasis (TNM) stage, with additional adjustment for potential prognostic factors.
  
  
  RESULTS
  Among 1562 patients, 548 (positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender (P = 0.004), minority (P < 0.001), tumor location (P = 0.001), pathological grade (P < 0.001), TNM stage (P < 0.001) and adjuvant radiotherapy (74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival (HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival (HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages (I and II). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival.
  
  
  CONCLUSIONS
  The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population.
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Guo-Shuang
authors.initials: GS
authors.lastname: Shen
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Jiu-Da
authors.initials: JD
authors.lastname: Zhao
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Jun-Hui
authors.initials: JH
authors.lastname: Zhao
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Xin-Fu
authors.initials: XF
authors.lastname: Ma
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Du
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Kan
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Fa-Xiang
authors.initials: FX
authors.lastname: Ji
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Ma
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Fang-Chao
authors.initials: FC
authors.lastname: Zheng
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Zi-Yi
authors.initials: ZY
authors.lastname: Wang
authors.affiliation: Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China.
authors.forename: Bing-He
authors.initials: BH
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012189:Retrospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Chinese population; Gastric cancer; Human epidermal growth receptor 2; Prognostic factors; R0 resection