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Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

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Abstract

Background

This study was designed to establish a prognostic score for gastric cancer that takes into account factors related to the tumor, the patient, and the treatment.

Methods

Two hundred thirty patients with gastric adenocarcinoma admitted t o the Department of Abdominal Surgery at Hospital do Câncer A. C. Camargo (São Paulo) and treated by gastrectomy from January 1992 until December 1996 were included in this retrospective cohort. The prognostic score was created according to the variables identified in the multivariate analysis and by using the regression coefficients generated by the Cox regression.

Results

The 5-year overall survival rate was 44.5%. The final multivariate model identified six variables with a significant and independent effect on survival: sex, weight loss, lymphocyte count, tumor-node-metastasis staging, lymphadenectomy, and lymph node ratio. Patients were divided into four groups according to their scores, as follows: group 1, 0 to 3.0; group 2, 3.5 to 5.5; group 3, 6.0 to 8.5; and group 4, 9.0 to 14.0. The 5-year survival rates were 91.5%, 49.3%, 20.3%, and .0% for the score groups 1, 2, 3, and 4, respectively (P < .001). The score was superior in the assessment of prognosis when compared with tumor-node-metastasis staging alone.

Conclusions

It is possible to create a prognostic score that simultaneously includes factors related to the tumor, patient, and treatment, thus generating a more effective system in predicting the prognosis than the morphology-based staging systems.

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Authors and Affiliations

  1. Hospital do Câncer A.C. Camargo, Fundação Antônio Prudente, Professor Antônio Prudente Street 211, São Paulo, SP, Brazil

    Marcelo Leite Vieira Costa MD, PhD, Karina de Cássia Braga Ribeiro DDS, PhD, Marcel Autran César Machado MD, PhD, Ana Carolina Leite Vieira Costa MD & André Luis Montagnini MD, PhD

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  1. Marcelo Leite Vieira Costa MD, PhD
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  2. Karina de Cássia Braga Ribeiro DDS, PhD
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  3. Marcel Autran César Machado MD, PhD
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  5. André Luis Montagnini MD, PhD
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Correspondence to Ana Carolina Leite Vieira Costa MD.

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Costa, M.L.V., Ribeiro, K.d.B., Machado, M.A.C. et al. Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors. Ann Surg Oncol 13, 843–850 (2006). https://doi.org/10.1245/ASO.2006.05.040

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