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Annals of Oncology Advance Access originally published online on February 13, 2007
Annals of Oncology 2007 18(5):886-891; doi:10.1093/annonc/mdl501
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© 2007 European Society for Medical Oncology

gastrointestinal tumors

Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma

J Lee1, T Lim1, JE Uhm1, KW Park4, SH Park5, SC Lee1, JO Park1, YS Park1, HY Lim1, TS Sohn2, JH Noh2, JS Heo2, CK Park3, S Kim2 and WK Kang1,*

1 Division of Hematology/Oncology
2 Department of Surgery
3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
4 Division of Hematology/Oncology, Department of Medicine, Dankook University Hospital, Cheonan
5 Division of Hematology and Oncology, Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, South Korea

* Correspondence to: Dr W. K. Kang, Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-gu, Seoul 135-710, South Korea. Tel: +82-2-3410-3451, Fax: +82-2-3410-0041; E-mail: wkkang{at}smc.samsung.co.kr

Background: This study was to devise a prognostic model for metastatic gastric cancer patients undergoing first-line chemotherapy.

Patients and methods: A retrospective analysis was carried out on 1455 gastric cancer patients, who received first-line chemotherapy from September 1994 to February 2005.

Results: At multivariate level, poor prognostic factors were no previous gastrectomy [P = 0.003; relative risk (RR), 1.191; 95% confidence interval (CI) 1.061–1.338], albumin <3.6 g/dl (P = <0.001; RR, 1.245; 95% CI 1.106–1.402), alkaline phosphatase >85 U/l (P = <0.001; RR, 1.224; 95% CI 1.092–1.371), Eastern Cooperative Oncology Group performance status of two or more (P = <0.001; RR, 1.690; 95% CI 1.458–1.959), the presence of bone metastases (P = 0.001; RR, 1.460; 95% CI 1.616–1.836), and the presence of ascites (P = <0.001; RR, 1.452; 95% CI 1.295–1.628). Of 1434 patients, 489 patients (34.1%) were categorized as low-risk group (zero to one factors), 889 patients (62.0%) as intermediate-risk group (two to four factors), and 56 patients (3.9%) as high-risk group (five to six factors). Median survival durations for low, intermediate, and high-risk groups were 12.5 months, 7.0 months, and 2.7 months, respectively.

Conclusions: This model should facilitate the individual patient risk stratification and thus, more appropriate therapies for each metastatic gastric cancer patient.

Key words: advanced gastric cancer, chemotherapy, prognosic factor

Received for publication October 31, 2006. Revision received December 17, 2006. Accepted for publication December 18, 2006.


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