Annals of Oncology Advance Access published online on February 13, 2007
Annals of Oncology, doi:10.1093/annonc/mdl501
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© 2007 European Society for Medical Oncology
Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma
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.
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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