Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer

Background: Accurate prediction of prognosis in gastro‐oesophageal cancer remains challenging. The aim of this study was to develop a robust model for outcome prediction. Methods: The study included 220 patients with gastric or oesophageal cancer newly diagnosed over a 2‐year period. Patients were s...

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Bibliographic Details
Published in:British journal of surgery 2007-12, Vol.94 (12), p.1501-1508
Main Authors: Deans, D. A. C., Wigmore, S. J., de Beaux, A. C., Paterson-Brown, S., Garden, O. J., Fearon, K. C. H.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
C-Reactive Protein - metabolism
Decision Making
Decision Support Techniques
Esophageal Neoplasms - blood
Esophageal Neoplasms - mortality
Female
General aspects
Humans
Male
Medical sciences
Middle Aged
Nutritional Status
Prognosis
Risk Assessment - methods
Severity of Illness Index
Stomach Neoplasms - blood
Stomach Neoplasms - mortality
Weight Loss
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Summary:Background: Accurate prediction of prognosis in gastro‐oesophageal cancer remains challenging. The aim of this study was to develop a robust model for outcome prediction. Methods: The study included 220 patients with gastric or oesophageal cancer newly diagnosed over a 2‐year period. Patients were staged and underwent treatment following discussion at a multidisciplinary team (MDT) meeting. Clinical and investigative variables were collected, including performance and nutritional status, and serum C‐reactive protein (CRP) level. Primary endpoints were death within 12 and 24 months. Results: Overall median survival was 13 months. Advanced clinical stage (P < 0·001), reduced performance score (P < 0·001), weight loss exceeding 2·75 per cent per month (P = 0·026) and serum CRP concentration above 5 mg/l (P = 0·031) were identified as independent prognostic indicators in multivariable analysis. A prognostic score was constructed using these four variables to estimate a probability of death. Applying the model gave an area under the receiver–operator characteristic curve of 0·84 and 0·85 for prediction of death at 12 and 24 months respectively (both P < 0·001). Conclusion: This model accurately estimated the probability of death within 12 and 24 months. This may aid the MDT decision‐making process. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. A useful tool for predicting death
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.5849