Zhang N, Li P, Wu X, et al. - Findings among patients managed surgically for advanced stage gastric cancer demonstrated a predictive impact of the tumor mutation burden (TMB) threshold level on the effect of surgical resection of D2 lymph node dissection, as well as showed that disease-free survival and overall survival of advanced gastric cancer patients can be significantly influenced by high levels of TMB.

• A total of 256 patients with advanced stage gastric cancer underwent surgical resection of D2 lymph node dissection.

• Relative to the high TMB group, longer disease-free survival period as well as overall survival period was observed in patients in the low-to-medium TMB group.

• By Pearson correlation analysis, there was a negative correlation of the TMB threshold with the disease-free survival and overall survival.

• Multivariate logistic analysis revealed a greater effect of high TMB thresholds on disease-free survival and overall survival, but the influence of medium and low TMB thresholds on disease-free survival and overall survival was weakened.