Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Performances of Prognostic Models in Stratifying Patients with Advanced Gastric Cancer Receiving First-line Chemotherapy: a Validation Study in a Chinese Cohort

  • Xu, Hui (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Zhang, Xiaopeng (Department of Noncommunicable Diseases and Health Education, Hefei Center for Disease Prevention and Control) ;
  • Wu, Zhijun (Department of Oncology, Ma'anshan Municipal People's Hospital) ;
  • Feng, Ying (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Zhang, Cheng (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Xie, Minmin (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Yang, Yahui (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Zhang, Yi (Department of Oncology, The First Affiliated Hospital of Anhui Medical University) ;
  • Feng, Chong (Department of Noncommunicable Diseases and Health Education, Hefei Center for Disease Prevention and Control) ;
  • Ma, Tai (Department of Oncology, The First Affiliated Hospital of Anhui Medical University)
  • Received : 2021.05.31
  • Accepted : 2021.09.17
  • Published : 2021.09.30
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Abstract

Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease. The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59-0.72), 0.60 (0.54-0.65), and 0.63 (0.56-0.69), respectively. Conclusions: Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.

Keywords

Acknowledgement

The authors gratefully acknowledge Mr. Zhenhui He for his help with data electronization.

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