Clinical Prognostic Scoring System for resectable gastric cancer predicts surviv
PUBLISHED: 2015-11-27  302 total views, 1 today

Xiaofeng Chen1, Jing Qian2, Yingying Qian2, Oluf dimitri Røe3, Yanhong Gu2,  Renhua Guo2, Yongmei Yin2, Yongqian Shu2

1Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, 2oncology, the First Affiliated Hospital of Nanjing Medical University, 3Cancer Research and Molecular Medicine, Norwegian University of Science and Technology

 

Objective:D2 gastrectomy is a standard procedure of curative resection for gastric cancer. This study aims to develop a simple and reliable prognostic scoring system for gastric cancer with D2 gastrectomy. Method:A prognostic scoring system was established based on clinical and laboratory data from 579 local gastric cancer patients with D2 gastrectomy. Result:From the multivariate model for overall survival (OS), five factors were selected for the scoring system: metastatic lymph node rate ≥50%, lympho vascular invasion positive, pTMN Stage II or III, preoperative carcinoembryonic antigen level ≥ 5 ng/mL and preoperative hemoglobin (P<0.001)while Model B differentiated low-, intermediate-, and high-riskpatients for OS (P<0.001). Stage III patients in the low risk group hadhigher survival probabilities than those who were stage II, but at high risk of death. Model A: AUC: 0.74 and Model B: AUC: 0.79 were both better predictors compared with the pTNM classification (AUC:0.62, P<0.001). Patients in the high-risk group could benefit from paclitaxel- or oxaliplatin-based or triplet adjuvant chemotherapy, but not those with low- and intermediate-risk. Conclusion: A more accurate andpractical prognostic risk scoring system has been established to predict OS of gastric cancer with D2 gastrectomy. Itcan identify the high-risk candidates in stage II or III for more intensive schedule and the selected subgroup who may benefit from paclitaxel- oroxaliplatin-based regimen before initiation of adjuvant chemotherapy.

 

Key Words: gastric cancer  prognosis  score system

 


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