基于对新辅助治疗反应的分析，我们开发了新辅助直肠癌评分（NAR），以作为局部晚期直肠癌患者5年总生存率（OS）的短期替代预测指标。本研究旨在评估该评分是否适用于新辅助化疗后行手术切除治疗的局部晚期胃腺癌患者。我们从全国癌症数据库中选取了接受新辅助系统治疗后行手术切除的胃腺癌患者。我们计算了新辅助胃癌（NAG）评分，并将患者分成低分、中分和高分三个类别，低分表示较长的生存期。我们对这些患者进行1:1:1的性别、年龄和病理特征匹配，以比较他们的OS。我们还在每个组内对接受辅助治疗的患者进行1:1的匹配，并比较他们的5年OS。共鉴定了2970名患者。NAG将患者分为低分组（n = 396, 13.3%）、中分组（n = 756, 25.5%）和高分组（n = 1818, 61.2%）。经过性别、年龄和病理特征匹配后，匹配组之间的5年OS存在显著差异（低分组-NAG 82%、中分组-NAG 73%、高分组-NAG 39%；p < 0.001）。NAG评分组别还能预测辅助治疗的OS效益；低分组和中分组患者在接受辅助治疗后OS无显著改善（86% vs. 84%；p = 0.492 和 77% vs. 74%；p = 0.382），而高分组患者在接受辅助治疗后5年OS有所改善（39% vs. 29%；p = 0.024）。NAR评分可用于生成胃腺癌的预后工具，以预测5年OS，并有潜力指导辅助治疗的决策。进一步研究应当从前瞻性角度验证这些结果，以确认临床可用性。© 2023. 外科肿瘤学会。

The Neoadjuvant Rectal score (NAR) was developed as a short-term surrogate for 5-year overall survival (OS) prediction in locally advanced rectal cancer on the basis of response to neoadjuvant therapy. We aim to assess whether this score can be repurposed for locally advanced gastric adenocarcinoma treated with neoadjuvant chemotherapy followed by surgical resection.Patients with gastric adenocarcinoma treated with neoadjuvant systemic therapy followed by surgical resection were extracted from the National Cancer Database. Neoadjuvant Gastric (NAG) scores were calculated, and patients were stratified into low-, intermediate-, and high-score categories, with low scores predicting longer survival. Patients were propensity-matched 1:1:1 between the groups for OS comparison. We also matched patients within each group 1:1 per receipt of adjuvant therapy and compared 5-year OS.There were 2,970 patients identified. NAG classified patients into low- (n = 396, 13.3%), intermediate-(n = 756, 25.5%), and high (n = 1818, 61.2%) groups. After propensity matching, 5-year OS was significantly different between the matched groups (low-NAG 82%, intermediate-NAG 73%, and high-NAG 39%; p < 0.001). NAG score grouping also predicted OS benefit of adjuvant therapy; low- and intermediate-NAG patients had no OS benefit with adjuvant therapy (86% vs. 84%; p = 0.492, and 77% vs. 74%; p = 0.382, respectively), whereas patients with high-NAG score had a 5-year OS benefit with adjuvant therapy (39% vs. 29%; p = 0.024).NAR score may be repurposed to generate a prognostic tool in gastric adenocarcinoma to predict 5-year OS and has the potential to guide decision-making regarding allocation of adjuvant therapy. Further studies should prospectively validate these findings to confirm clinical utility.© 2023. Society of Surgical Oncology.