Prediction of Response and Prognosis by a Score Including only Pretherapeutic Parameters in 410 Neoadjuvant Treated Gastric Cancer Patients

Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 196)

Abstract

Introduction: Response to neoadjuvant chemotherapy (NAC) is an independent prognostic factor in locally advanced gastric cancer. However, no prospectively tested pretherapeutic parameters predicting response and/or survival in gastric cancer are available in clinical routine. Patients and methods: We evaluated the prognostic significance of various clinicopathologic parameters in 410 patients who were treated with NAC followed by gastrectomy. Clinical and histopathological response evaluation was performed using standardized criteria. A prognostic score was created on the basis of the variables identified in the multivariate analysis. Results: Multivariate analysis identified three pretherapeutic parameters as positive predictive factors for response and prognosis: tumor localization in the middle third of the stomach (p = 0.001), well differentiated tumors (p = 0.001) and intestinal tumor type according to Laurén’s classification (p = 0.03). From the obtained data a prognostic index was constructed, dividing the patients into three risk groups: low (n = 73), intermediate (n = 274), and poor (n = 63). The three groups had significantly different clinical (p = 0.007) and histopathological response rates (p = 0.001) and survival times, with a median survival time that was not reached in the low-risk group, 39.2 months in the intermediate-risk group and 20.5 months in the poor-risk group. The corresponding 5-year survival rates were 65.3, 41.2, and 21.2 % (p < 0.001), respectively. Conclusion: A simple scoring system based on three clinicopathologic parameters, accurately predicts response and prognosis in neoadjuvant treated gastric cancer. This system provides additional useful information that could be applied to select gastric cancer patients pretherapeutically for different treatment approaches. Prospective testing of the score in an independent patient cohort is warranted.

Keywords

Gastric Cancer Gastric Cancer Patient Advanced Gastric Cancer Prognostic Index Histopathological Response 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.National Center of Tumor Diseases, University of HeidelbergHeidelbergGermany
  2. 2.Department of SurgeryUniversity Hospital of HeidelbergHeidelbergGermany

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