{
    "info": {
        "nct_id": "NCT06673472",
        "official_title": "Comparison of Long-term Outcomes Between Upfront Surgery and Neoadjuvant Therapy Followed by Surgery in Patients with Node-Negative Gastric Cancer: a Propensity Score Matched International Multicenter Study",
        "inclusion_criteria": "(1) preoperative clinical staging of cT2-4NxM0; (2) primary gastric adenocarcinoma confirmed via pathology; (3) no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT; (4) underwent radical gastrectomy (R0) and D2 lymphadenectomy; (5) postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative); and (6) follow-up for at least 3 years.\nHealthy volunteers allowed\nMust have minimum age of 18 Years\nMust have maximum age of 80 Years",
        "exclusion_criteria": "(1) considered early-stage gastric cancer before surgery; (2) distant metastasis detected preoperatively or intraoperatively; (3) failure to achieve R0 resection and D2 lymphadenectomy during surgery; (4) concurrent diagnosis of other malignancies; (5) remnant gastric cancer; (6) death within 30 days postoperatively; and (7) incomplete baseline data or follow-up records.",
        "miscellaneous_criteria": ""
    },
    "inclusion_lines": [
        {
            "identified_line": {
                "line": "(1) preoperative clinical staging of cT2-4NxM0; (2) primary gastric adenocarcinoma confirmed via pathology; (3) no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT; (4) underwent radical gastrectomy (R0) and D2 lymphadenectomy; (5) postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative); and (6) follow-up for at least 3 years.",
                "criterions": [
                    {
                        "exact_snippets": "preoperative clinical staging of cT2-4NxM0",
                        "criterion": "clinical staging",
                        "requirement": {
                            "requirement_type": "stage",
                            "expected_value": "cT2-4NxM0"
                        }
                    },
                    {
                        "exact_snippets": "primary gastric adenocarcinoma confirmed via pathology",
                        "criterion": "gastric adenocarcinoma",
                        "requirement": {
                            "requirement_type": "confirmation",
                            "expected_value": "pathology"
                        }
                    },
                    {
                        "exact_snippets": "no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT",
                        "criterion": "distant metastasis",
                        "requirement": {
                            "requirement_type": "absence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT",
                        "criterion": "distant metastasis",
                        "requirement": {
                            "requirement_type": "confirmation",
                            "expected_value": [
                                "preoperative chest X-ray",
                                "chest CT",
                                "abdominal ultrasound",
                                "abdominal CT"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "underwent radical gastrectomy (R0) and D2 lymphadenectomy",
                        "criterion": "surgical procedure",
                        "requirement": {
                            "requirement_type": "type",
                            "expected_value": [
                                "radical gastrectomy (R0)",
                                "D2 lymphadenectomy"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative)",
                        "criterion": "lymph node metastasis",
                        "requirement": {
                            "requirement_type": "confirmation",
                            "expected_value": "postoperative pathology"
                        }
                    },
                    {
                        "exact_snippets": "postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative)",
                        "criterion": "lymph node metastasis",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "negative"
                        }
                    },
                    {
                        "exact_snippets": "follow-up for at least 3 years",
                        "criterion": "follow-up duration",
                        "requirement": {
                            "requirement_type": "duration",
                            "expected_value": {
                                "operator": ">=",
                                "value": 3,
                                "unit": "years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "and_criteria": [
                                    {
                                        "and_criteria": [
                                            {
                                                "and_criteria": [
                                                    {
                                                        "and_criteria": [
                                                            {
                                                                "exact_snippets": "preoperative clinical staging of cT2-4NxM0",
                                                                "criterion": "clinical staging",
                                                                "requirement": {
                                                                    "requirement_type": "stage",
                                                                    "expected_value": "cT2-4NxM0"
                                                                }
                                                            },
                                                            {
                                                                "exact_snippets": "primary gastric adenocarcinoma confirmed via pathology",
                                                                "criterion": "gastric adenocarcinoma",
                                                                "requirement": {
                                                                    "requirement_type": "confirmation",
                                                                    "expected_value": "pathology"
                                                                }
                                                            }
                                                        ]
                                                    },
                                                    {
                                                        "and_criteria": [
                                                            {
                                                                "exact_snippets": "no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT",
                                                                "criterion": "distant metastasis",
                                                                "requirement": {
                                                                    "requirement_type": "absence",
                                                                    "expected_value": true
                                                                }
                                                            },
                                                            {
                                                                "exact_snippets": "no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest X-ray or chest CT, abdominal ultrasound, and abdominal CT",
                                                                "criterion": "distant metastasis",
                                                                "requirement": {
                                                                    "requirement_type": "confirmation",
                                                                    "expected_value": [
                                                                        "preoperative chest X-ray",
                                                                        "chest CT",
                                                                        "abdominal ultrasound",
                                                                        "abdominal CT"
                                                                    ]
                                                                }
                                                            }
                                                        ]
                                                    }
                                                ]
                                            },
                                            {
                                                "exact_snippets": "underwent radical gastrectomy (R0) and D2 lymphadenectomy",
                                                "criterion": "surgical procedure",
                                                "requirement": {
                                                    "requirement_type": "type",
                                                    "expected_value": [
                                                        "radical gastrectomy (R0)",
                                                        "D2 lymphadenectomy"
                                                    ]
                                                }
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "and_criteria": [
                                    {
                                        "exact_snippets": "postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative)",
                                        "criterion": "lymph node metastasis",
                                        "requirement": {
                                            "requirement_type": "confirmation",
                                            "expected_value": "postoperative pathology"
                                        }
                                    },
                                    {
                                        "exact_snippets": "postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative)",
                                        "criterion": "lymph node metastasis",
                                        "requirement": {
                                            "requirement_type": "status",
                                            "expected_value": "negative"
                                        }
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "exact_snippets": "follow-up for at least 3 years",
                        "criterion": "follow-up duration",
                        "requirement": {
                            "requirement_type": "duration",
                            "expected_value": {
                                "operator": ">=",
                                "value": 3,
                                "unit": "years"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Healthy volunteers allowed",
                "criterions": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must have minimum age of 18 Years",
                "criterions": [
                    {
                        "exact_snippets": "minimum age of 18 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "minimum age of 18 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must have maximum age of 80 Years",
                "criterions": [
                    {
                        "exact_snippets": "maximum age of 80 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "maximum",
                            "expected_value": {
                                "operator": "<=",
                                "value": 80,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "maximum age of 80 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "maximum",
                            "expected_value": {
                                "operator": "<=",
                                "value": 80,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            }
        }
    ],
    "exclusion_lines": [
        {
            "identified_line": {
                "line": "(1) considered early-stage gastric cancer before surgery; (2) distant metastasis detected preoperatively or intraoperatively; (3) failure to achieve R0 resection and D2 lymphadenectomy during surgery; (4) concurrent diagnosis of other malignancies; (5) remnant gastric cancer; (6) death within 30 days postoperatively; and (7) incomplete baseline data or follow-up records.",
                "criterions": [
                    {
                        "exact_snippets": "considered early-stage gastric cancer before surgery",
                        "criterion": "early-stage gastric cancer",
                        "requirement": {
                            "requirement_type": "stage",
                            "expected_value": "early-stage"
                        }
                    },
                    {
                        "exact_snippets": "distant metastasis detected preoperatively or intraoperatively",
                        "criterion": "distant metastasis",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "failure to achieve R0 resection and D2 lymphadenectomy during surgery",
                        "criterion": "R0 resection",
                        "requirement": {
                            "requirement_type": "achievement",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "failure to achieve R0 resection and D2 lymphadenectomy during surgery",
                        "criterion": "D2 lymphadenectomy",
                        "requirement": {
                            "requirement_type": "achievement",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "concurrent diagnosis of other malignancies",
                        "criterion": "other malignancies",
                        "requirement": {
                            "requirement_type": "diagnosis",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "remnant gastric cancer",
                        "criterion": "remnant gastric cancer",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "death within 30 days postoperatively",
                        "criterion": "death",
                        "requirement": {
                            "requirement_type": "timeframe",
                            "expected_value": {
                                "operator": "<=",
                                "value": 30,
                                "unit": "days"
                            }
                        }
                    },
                    {
                        "exact_snippets": "incomplete baseline data or follow-up records",
                        "criterion": "baseline data",
                        "requirement": {
                            "requirement_type": "completeness",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "incomplete baseline data or follow-up records",
                        "criterion": "follow-up records",
                        "requirement": {
                            "requirement_type": "completeness",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "not_criteria": {
                                    "exact_snippets": "considered early-stage gastric cancer before surgery",
                                    "criterion": "early-stage gastric cancer",
                                    "requirement": {
                                        "requirement_type": "stage",
                                        "expected_value": "early-stage"
                                    }
                                }
                            },
                            {
                                "exact_snippets": "distant metastasis detected preoperatively or intraoperatively",
                                "criterion": "distant metastasis",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            },
                            {
                                "and_criteria": [
                                    {
                                        "exact_snippets": "failure to achieve R0 resection and D2 lymphadenectomy during surgery",
                                        "criterion": "R0 resection",
                                        "requirement": {
                                            "requirement_type": "achievement",
                                            "expected_value": false
                                        }
                                    },
                                    {
                                        "exact_snippets": "failure to achieve R0 resection and D2 lymphadenectomy during surgery",
                                        "criterion": "D2 lymphadenectomy",
                                        "requirement": {
                                            "requirement_type": "achievement",
                                            "expected_value": false
                                        }
                                    }
                                ]
                            },
                            {
                                "exact_snippets": "concurrent diagnosis of other malignancies",
                                "criterion": "other malignancies",
                                "requirement": {
                                    "requirement_type": "diagnosis",
                                    "expected_value": true
                                }
                            },
                            {
                                "exact_snippets": "remnant gastric cancer",
                                "criterion": "remnant gastric cancer",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            },
                            {
                                "exact_snippets": "death within 30 days postoperatively",
                                "criterion": "death",
                                "requirement": {
                                    "requirement_type": "timeframe",
                                    "expected_value": {
                                        "operator": "<=",
                                        "value": 30,
                                        "unit": "days"
                                    }
                                }
                            },
                            {
                                "or_criteria": [
                                    {
                                        "exact_snippets": "incomplete baseline data or follow-up records",
                                        "criterion": "baseline data",
                                        "requirement": {
                                            "requirement_type": "completeness",
                                            "expected_value": false
                                        }
                                    },
                                    {
                                        "exact_snippets": "incomplete baseline data or follow-up records",
                                        "criterion": "follow-up records",
                                        "requirement": {
                                            "requirement_type": "completeness",
                                            "expected_value": false
                                        }
                                    }
                                ]
                            }
                        ]
                    }
                ]
            }
        }
    ],
    "miscellaneous_lines": [],
    "failed_inclusion": [],
    "failed_exclusion": [],
    "failed_miscellaneous": []
}