Koo DH, Ryu MH, Lee MY, Moon MS, Kang YK. New prognostic model for patients with advanced gastric cancer: Fluoropyrimidine/platinum doublet for first-line chemotherapy. World J Gastroenterol 2021; 27(48): 8357-8369 [PMID: 35068874 DOI: 10.3748/wjg.v27.i48.8357]
Corresponding Author of This Article
Yoon-Koo Kang, MD, PhD, Professor, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. ykkang@amc.seoul.kr
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 28, 2021; 27(48): 8357-8369 Published online Dec 28, 2021. doi: 10.3748/wjg.v27.i48.8357
New prognostic model for patients with advanced gastric cancer: Fluoropyrimidine/platinum doublet for first-line chemotherapy
Dong-Hoe Koo, Min-Hee Ryu, Mi-Yeon Lee, Mee-Sun Moon, Yoon-Koo Kang
Dong-Hoe Koo, Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
Min-Hee Ryu, Mee-Sun Moon, Yoon-Koo Kang, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
Mi-Yeon Lee, Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Seoul 03181, South Korea
Author contributions: Koo DH, Ryu MH, and Kang YK contributed to the conception and design of the study; Kang YK, Ryu MH, and Moon MS collected the data; Koo DH, Lee MY, Kang YK, and Ryu MH performed the analysis; Koo DH, Ryu MH, and Kang YK wrote the paper; all authors contributed to manuscript revision and read and approved the submitted version.
Institutional review board statement: The Institutional Review Board of Asan Medical Center approved the study protocol (2020-0574).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No conflicts of interest relevant to this article are reported.
Data sharing statement: The data presented in this study are available on request from the corresponding author. The data are not publicly available due to a privacy issue from the patients.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yoon-Koo Kang, MD, PhD, Professor, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. ykkang@amc.seoul.kr
Received: July 12, 2021 Peer-review started: July 12, 2021 First decision: October 3, 2021 Revised: October 9, 2021 Accepted: November 30, 2021 Article in press: November 30, 2021 Published online: December 28, 2021 Processing time: 164 Days and 19.7 Hours
Abstract
BACKGROUND
New prognostic factors have been reported in patients with metastatic or recurrent gastric cancer (MRGC), necessitating modifications to the previous prognostic model.
AIM
To develop a new model, MRGC patients who received fluoropyrimidines/ platinum doublet chemotherapy between 2008 and 2015 were analyzed.
METHODS
A total of 1883 patients was divided into a training set (n = 937) and an independent validation set (n = 946).
RESULTS
Multivariate analysis showed that the following six factors were associated with poor overall survival (OS) in the training set: Eastern Cooperative Oncology Group performance score ≥ 2 and bone metastasis (2 points each), peritoneal metastasis, high alkaline phosphatase level, low albumin level, and high neutrophil-lymphocyte ratio (1 point each). A prognostic model was developed by stratifying patients into good (0-1 point), moderate (2-3 points), and poor (≥ 4 points) risk groups. In the validation set, the median OS of the three risk groups was 15.8, 10.1, and 5.7 mo, respectively, and those differences were significant (P < 0.001).
CONCLUSION
We identified six factors readily measured in clinical practice that are predictive of poor prognosis in patients with MRGC. The new model is simpler than the old and more easily predicts OS.
Core Tip: A new prognostic model for patients with metastatic or recurrent gastric cancer was developed using six clinicopathological elements (poor Eastern Cooperative Oncology Group performance score, bone metastasis, peritoneal metastasis, high alkaline phosphatase level, low albumin level, and high neutrophil-lymphocyte ratio).
