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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2012

01-07-2012 | Gastrointestinal Oncology

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

Authors: Sylvie Lorenzen, MD, PhD, Susanne Blank, MD, Florian Lordick, MD, PhD, Jörg-Rüdiger Siewert, MD, PhD, Katja Ott, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2012

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Abstract

Background

Response to neoadjuvant chemotherapy 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.

Methods

We evaluated the prognostic significance of various clinical pathologic parameters in 410 patients who were treated with neoadjuvant chemotherapy followed by gastrectomy. Clinical and histopathologic response evaluation was performed by using standardized criteria. A prognostic score was created on the basis of the variables identified in the multivariate analysis.

Results

Three pretherapeutic parameters were identified 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 classification (P = 0.03). A prognostic index was constructed, dividing the patients into three risk groups: low (n = 73), intermediate (n = 274), and high (n = 63). The three groups had significantly different clinical (P = 0.007) and histopathologic 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 high-risk group. The corresponding 5-year survival rates were 65.3, 41.2, and 21.2% (P < 0.001), respectively.

Conclusions

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.
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Metadata
Title
Prediction of Response and Prognosis by a Score Including Only Pretherapeutic Parameters in 410 Neoadjuvant Treated Gastric Cancer Patients
Authors
Sylvie Lorenzen, MD, PhD
Susanne Blank, MD
Florian Lordick, MD, PhD
Jörg-Rüdiger Siewert, MD, PhD
Katja Ott, MD, PhD
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2254-1

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