Qian et al reported a prognostic score for a patient with a resectable gastric cancer. This can help to identify a patient likely to benefit from platinum-based chemotherapy. The authors are from multiple institutions in China, Denmark and Norway.
Patient selection: resectable gastric cancer
Parameters:
(1) UICC TNM stage
(2) metastatic lymph node ratio
(3) lymphovascular invasion
(4) pre-operative serum CEA concentration in ng/mL
(5) pre-operative hemoglobin in g/L
|
Parameter
|
Finding
|
Points
|
|
UICC TNM stage
|
I
|
0
|
|
|
II
|
2
|
|
|
III
|
3
|
|
metastatic LN ratio
|
<= 50%
|
0
|
|
|
> 50%
|
2
|
|
lymphovascular invasion
|
no
|
0
|
|
|
yes
|
2
|
|
CEA level
|
< 5 ng/mL
|
0
|
|
|
>= 5 ng/mL
|
1
|
|
hemoglobin
|
>= 110 g/L
|
0
|
|
|
< 110 g/L
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk. In Model A a score > 6 is high risk. In Model B a score > 7 is high.
• A score >6 is associated with benefit from paclitaxel therapy.
• A score > 7 is associated with benefit from paclitaxel or oxaliplatin therapy.
Performance:
• For model A the area under the ROC curve was 0.74.
• For model B the area under the ROC curve was 0.79.
