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18-3.11, P less then 0.02) and among patients who received surgery only. The TME risk score provided additional prognostic value beyond stage, and combination of the two improved prognostication accuracy (likelihood-ratio test χ2 = 235.4 vs. 187.6, P less then 0.0001; net reclassification index 23%). The TME risk score can predict the survival benefit of adjuvant chemotherapy in non-metastatic patients (stage I-III) (interaction test P less then 0.02). Patients were divided into four TME subtypes that demonstrated distinct genetic and m