Prognostic Evaluation of a Multicenter Cohort of 484 Patients with Metastatic Gastroesophageal Adenocarcinoma
| Autor: | Estela Pineda, Laura Visa, E. Jofré, C. Murias, C. Giraldo, P. Jimenez Fonseca, Alberto Carmona-Bayonas, Nadia Hindi, C. Lopez, Marcelo Garrido, Ana Custodio, J. Gallego Plazas, M. Mugica, M.A. Vicente Conesa, S. Fernandez Arrojo, Vega Iranzo, Avinash Ramchandani, L. Faez Garcia, E. Buxo, F. Erpel |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
medicine.medical_specialty Performance status biology business.industry Hazard ratio Combination chemotherapy Hematology medicine.disease Chemotherapy regimen Carcinoembryonic antigen Internal medicine medicine biology.protein Adenocarcinoma Progression-free survival business Survival analysis |
| Zdroj: | Annals of Oncology. 25:iv217 |
| ISSN: | 0923-7534 |
| DOI: | 10.1093/annonc/mdu334.19 |
| Popis: | Aim: To analyze the prognostic factors in patients with metastatic gastroesophageal adenocarcinoma treated with first-line chemotherapy. Methods: A retrospective analysis was carried out on 484 patients who received first-line combined chemotherapy from 2004 to 2013. We used the multivariate Cox proportional hazards regression with bootstrap resampling to identify prognostic factors for overall survival (OS). Results: 356 (75%) patients have died with a median progression-free survival (PFS) and OS of: 6.2 (95%CI, 5.6-6.7) and 10.7 (95%CI, 9.4-12.1) months, respectively. Eight independent prognostic factors were identified in the multivariate analysis: two or more chronic comorbidities (hazard ratio [HR] 1.19; 95%CI, 1.04-1.36), European Cooperative Oncology Group (ECOG) performance status ≥2 (HR 1.40; 95%CI, 0.99-2.14), presence of signet ring cells (HR, 1.37; 95% CI, 1.07-1.72), Her2-overexpressing tumors treated with trastuzumab (HR, 0.71; 95% CI, 0.50-0.96), two or more sites of metastatic disease (HR 1.26; 95%CI, 1.08-1.63), carcinoembryonic antigen (CEA) ≥20 ng/ml (HR, 1.32; 95% CI, 1.23-1.69), presence of bone metastasis (HR, 1.99; 95% CI, 1.37-2.87) and ascitis (HR, 1.67; 95% CI, 1.26-2.21). We integrated these variables into a prognostic index with patients classified as low (n = 84), moderate (n = 324) and poor (n = 42) risk categories, with median OS: 13.9, 8.9 and 6.2 months, respectively (p Conclusions: We have identified eight prognostic factors that could stratify patients and individualize therapeutic strategies in metastatic gastroesophageal adenocarcinoma setting. Disclosure: All authors have declared no conflicts of interest. |
| Databáze: | OpenAIRE |
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