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

  • Conference paper
  • First Online:
Early Gastrointestinal Cancers

Part of the book series: Recent Results in Cancer Research ((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.

Original paper is published in Ann Surg Oncol. 2012 Mar 7. [Epub ahead of print]

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  1. National Center of Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Lorenzen Sylvie

  2. Department of Surgery, University Hospital of Heidelberg, Heidelberg, Germany

    Blank Susanne & Ott Katja

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  1. Lorenzen Sylvie
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  2. Blank Susanne
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Correspondence to Lorenzen Sylvie .

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  1. Tumor- und Brustzentrum ZeTuP AG, Rorschacherstr. 150, St. Gallen, 9006, Switzerland

    Florian Otto

  2. Rheinstr. 2, Saarbrücken, 66113, Germany

    Manfred P. Lutz

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Sylvie, L., Susanne, B., Katja, O. (2012). Prediction of Response and Prognosis by a Score Including only Pretherapeutic Parameters in 410 Neoadjuvant Treated Gastric Cancer Patients. In: Otto, F., Lutz, M. (eds) Early Gastrointestinal Cancers. Recent Results in Cancer Research, vol 196. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31629-6_18

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