MELD-sodium score and its prognostic value in malignancy-related ascites of pancreatic and gastric cancer

Malignant ascites is a manifestation of end-stage events in a variety of cancers. There is significant lack of possible survival predictors in patients with malignancy-related ascites. Since the Model for End-Stage Liver Disease (MELD)-Na score has been shown to be a feasible and independent prognostic predictor for both short- and long-term outcome in HCC patients, we decided to test its prognostic role in other cancer types with ascites.

This is a retrospective study. The outpatient oncology clinic’s records were screened for the period between 2004 and 2011. Eighty-two pancreatic and gastric cancer patients were enrolled into the study.

The median age of patients was 59 (±12). Fifty-nine patients had gastric cancer and 23 had pancreatic cancer. Overall survival (OS) was 16.8 (IR, 1–98) months in gastric cancer and 16.3 (IR, 0.5–81) months in pancreatic cancer. There was no statistically significant difference between OS of gastric and pancreatic cancer. Progression-free survival (PFS) was statistically significantly longer in gastric cancer than pancreatic cancer with 16.5 (IR, 0.5–90) vs 6.5 (IR, 0.4–34) months (P = 0.04). Further analysis of data included stepwise multiple regression analysis with the dependent variable “overall survival.” The model had two independent predictors and an R ² of 82 % and a predicted R ² of 81 %. Predictors for time to remission were PFS and MELD-Na. The regression equation for the model was: \( \mathrm{Overall}\;\mathrm{survival}=17.4-0.522\,\,\mathrm{MELD}\text{-}\mathrm{Na} + 0.902\;\mathrm{PFS} \)

In this study we showed that progression-free survival and MELD-Na score are significantly related with overall survival. MELD-Na score can be one of the predictors of the survival and PFS in pancreatic and gastric cancer patients with ascites.