{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:01:02Z","timestamp":1792094462960,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"43","license":[{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["advanced.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advanced Science"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate prediction of early postoperative recurrence in locally advanced gastric cancer (LAGC) remains challenging due to tumor heterogeneity and limitations of traditional clinicopathological factors. This study aims to develop and validate an interpretable multimodal model for precise recurrence prediction. 1580 LAGC patients are enrolled from six Chinese medical centers and a multimodal fusion Risk Stratification Assessment (RSA) model integrating clinical, radiomic, and pathomic data is developed. Model performance is evaluated using internal, external, prospective, and public dataset validations. Transcriptome sequencing is conducted to elucidate biological mechanisms underlying recurrence. The RSA model significantly outperforms clinical\u2010only, radiomic\u2010only, and pathomic\u2010only models in predicting early recurrence, achieving area under the curve (AUC) values of 0.903 in the training cohort, 0.902 in internal validation, and ranging from 0.884 to 0.889 in external validations. Stratification by the RSA model consistently identifies high\u2010risk patients with significantly poorer five\u2010year survival across all cohorts (all P&lt;0.001). Transcriptomic analysis reveals that high\u2010risk patients exhibit significant immune cell infiltration, increased expression of immune checkpoint molecules, and activation of immune\u2010related pathways, including interferon signaling and the IL\u20106\/JAK\/STAT3 pathway. The integrated multimodal RSA model effectively predicts recurrence risk and prognosis in LAGC, enabling precise patient stratification and individualized postoperative management.<\/jats:p>","DOI":"10.1002\/advs.202508190","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T17:10:02Z","timestamp":1757783402000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Interpretable Multimodal Fusion Model Enhances Postoperative Recurrence Prediction in Gastric Cancer"],"prefix":"10.1002","volume":"12","author":[{"given":"Ping'an","family":"Ding","sequence":"first","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer  Shijiazhuang Hebei 050011 China"},{"name":"Big data analysis and mining application for precise diagnosis and treatment of gastric cancer Hebei Provincial Engineering Research Center  Shijiazhuang Hebei 050011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxuan","family":"Yang","sequence":"additional","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer  Shijiazhuang Hebei 050011 China"},{"name":"Big data analysis and mining application for precise diagnosis and treatment of gastric cancer Hebei Provincial Engineering Research Center  Shijiazhuang Hebei 050011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Clinical College of Hebei University  Baoding Hebei 071000 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghai","family":"Guo","sequence":"additional","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer  Shijiazhuang Hebei 050011 China"},{"name":"Big data analysis and mining application for precise diagnosis and treatment of gastric cancer Hebei Provincial Engineering Research Center  Shijiazhuang Hebei 050011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Wu","sequence":"additional","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer  Shijiazhuang Hebei 050011 China"},{"name":"Big data analysis and mining application for precise diagnosis and treatment of gastric cancer Hebei Provincial Engineering Research Center  Shijiazhuang Hebei 050011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Wu","sequence":"additional","affiliation":[{"name":"The Third Department of Surgery the Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 China"},{"name":"Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer  Shijiazhuang Hebei 050011 China"},{"name":"Big data analysis and mining application for precise diagnosis and treatment of gastric cancer Hebei Provincial Engineering Research Center  Shijiazhuang Hebei 050011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[{"name":"The Department of CT\/MRI The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 050011 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