Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma

Background: This study was to devise a prognostic model for metastatic gastric cancer patients undergoing first-line chemotherapy. Patients and methods: A retrospective analysis was carried out on 1455 gastric cancer patients, who received first-line chemotherapy from September 1994 to February 2005. Results: At multivariate level, poor prognostic factors were no previous gastrectomy [P = 0.003; relative risk (RR), 1.191; 95% confidence interval (Cl) 1.061-1.3381, albumin <3.6 g/dl (P = <0.001; RR, 1.245; 95% CI 1.106-1.402), alkaline phosphatase >85 U/I (P = <0.001; RR, 1.224; 95% Cl 1.092-1.371), Eastern Cooperative Oncology Group performance status of two or more (P = <0.001; RR, 1.690; 95% Cl 1.458-1.959), the presence of bone metastases (P = 0.001; RR, 1.460; 95% Cl 1.616-1.836), and the presence of ascites (P = <0.001; RR, 1.452; 95% Cl 1.2951.628). Of 1434 patients, 489 patients (34.1%) were categorized as low-risk group (zero to one factors), 889 patients (62.0%) as intermediate-risk group (two to four factors), and 56 patients (3.9%) as high-risk group (five to six factors). Median survival durations for low, intermediate, and high-risk groups were 12.5 months, 7.0 months, and 2.7 months, respectively. Conclusions: This model should facilitate the individual patient risk stratification and thus, more appropriate therapies for each metastatic gastric cancer patient.