Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer
Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer
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DOI：
10.1002/bjs.5849
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发表时间：
2007-12-01
影响因子：
9.6
通讯作者：
Fearon, K. C. H.
中科院分区：
文献类型：
--
作者：
Deans, D. A. C.;Wigmore, S. J.;Fearon, K. C. H.
背景：准确预测胃食管癌的预后仍然具有挑战性。本研究的目的是开发一个强大的模型为outcome prediction.Methods：本研究包括220例胃癌或食管癌新诊断超过2年的时间。在多学科小组（MDT）会议讨论后，对患者进行分期和治疗。收集临床和研究变量，包括性能和营养状况，以及血清C反应蛋白（CRP）水平。主要终点为12和24个月内的死亡。结果：总的中位生存期为13个月。在多变量分析中，晚期临床分期（P <0.001）、体能评分降低（P < 0.001）、每月体重减轻超过2.75%（P = 0.026）和血清CRIP浓度高于5 mg/l（P = 0.031）被确定为独立的预后指标。使用这四个变量构建预后评分以估计死亡概率。应用该模型预测12个月和24个月死亡的受试者-操作者特征曲线下面积分别为0.84和0.85（均P < 0.001）。这可能有助于MDT决策过程。
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 CRIP 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.