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Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer

BACKGROUND: Prognostic scores that can identify patients at risk for early death are needed to aid treatment decision-making and patient selection for clinical trials. We compared the accuracy of four scores to predict early death (within 90 days) and overall survival (OS) in patients with metastati...

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Autores principales: Ma, Lucy X, Espin-Garcia, Osvaldo, Bach, Yvonne, Aoyama, Hiroko, Allen, Michael J, Wang, Xin, Darling, Gail E, Yeung, Jonathan, Swallow, Carol J, Brar, Savtaj, Veit-Haibach, Patrick, Kalimuthu, Sangeetha, Wong, Rebecca, Chen, Eric X, O’Kane, Grainne M, Jang, Raymond W, Elimova, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020804/
https://www.ncbi.nlm.nih.gov/pubmed/36378560
http://dx.doi.org/10.1093/oncolo/oyac235
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author Ma, Lucy X
Espin-Garcia, Osvaldo
Bach, Yvonne
Aoyama, Hiroko
Allen, Michael J
Wang, Xin
Darling, Gail E
Yeung, Jonathan
Swallow, Carol J
Brar, Savtaj
Veit-Haibach, Patrick
Kalimuthu, Sangeetha
Wong, Rebecca
Chen, Eric X
O’Kane, Grainne M
Jang, Raymond W
Elimova, Elena
author_facet Ma, Lucy X
Espin-Garcia, Osvaldo
Bach, Yvonne
Aoyama, Hiroko
Allen, Michael J
Wang, Xin
Darling, Gail E
Yeung, Jonathan
Swallow, Carol J
Brar, Savtaj
Veit-Haibach, Patrick
Kalimuthu, Sangeetha
Wong, Rebecca
Chen, Eric X
O’Kane, Grainne M
Jang, Raymond W
Elimova, Elena
author_sort Ma, Lucy X
collection PubMed
description BACKGROUND: Prognostic scores that can identify patients at risk for early death are needed to aid treatment decision-making and patient selection for clinical trials. We compared the accuracy of four scores to predict early death (within 90 days) and overall survival (OS) in patients with metastatic gastric and esophageal (GE) cancer. METHODS: Advanced GE cancer patients receiving first-line systemic therapy were included. Prognostic risks were calculated using: Royal Marsden Hospital (RMH), MD Anderson Cancer Centre (MDACC), Gustave Roussy Immune (GRIm-Score), and MD Anderson Immune Checkpoint Inhibitor (MDA-ICI) scores. Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazards models were used to analyze associations between prognostic scores and OS. The predictive discrimination was estimated using Harrell’s c-index. Predictive ability for early death was measured using time-dependent AUCs. RESULTS: In total, 451 patients with metastatic GE cancer were included. High risk patients had shorter OS for all scores (RMH high- vs. low–risk median OS 7.9 vs. 12.2 months, P < .001; MDACC 6.8 vs. 11.9 months P < .001; GRIm-Score 5.3 vs. 13 months, P < .001; MDA-ICI 8.2 vs. 12.2 months, P < .001). On multivariable analysis, each prognostic score was significantly associated with OS. The GRIm-Score had the highest predictive discrimination and predictive ability for early death. CONCLUSIONS: The GRIm-Score had the highest accuracy in predicting early death and OS. Clinicians may use this score to identify patients at higher risk of early death to guide treatment decisions including clinical trial enrolment. This score could also be used as a stratification factor in future clinical trial designs.
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spelling pubmed-100208042023-03-18 Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer Ma, Lucy X Espin-Garcia, Osvaldo Bach, Yvonne Aoyama, Hiroko Allen, Michael J Wang, Xin Darling, Gail E Yeung, Jonathan Swallow, Carol J Brar, Savtaj Veit-Haibach, Patrick Kalimuthu, Sangeetha Wong, Rebecca Chen, Eric X O’Kane, Grainne M Jang, Raymond W Elimova, Elena Oncologist Gastrointestinal Cancer BACKGROUND: Prognostic scores that can identify patients at risk for early death are needed to aid treatment decision-making and patient selection for clinical trials. We compared the accuracy of four scores to predict early death (within 90 days) and overall survival (OS) in patients with metastatic gastric and esophageal (GE) cancer. METHODS: Advanced GE cancer patients receiving first-line systemic therapy were included. Prognostic risks were calculated using: Royal Marsden Hospital (RMH), MD Anderson Cancer Centre (MDACC), Gustave Roussy Immune (GRIm-Score), and MD Anderson Immune Checkpoint Inhibitor (MDA-ICI) scores. Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazards models were used to analyze associations between prognostic scores and OS. The predictive discrimination was estimated using Harrell’s c-index. Predictive ability for early death was measured using time-dependent AUCs. RESULTS: In total, 451 patients with metastatic GE cancer were included. High risk patients had shorter OS for all scores (RMH high- vs. low–risk median OS 7.9 vs. 12.2 months, P < .001; MDACC 6.8 vs. 11.9 months P < .001; GRIm-Score 5.3 vs. 13 months, P < .001; MDA-ICI 8.2 vs. 12.2 months, P < .001). On multivariable analysis, each prognostic score was significantly associated with OS. The GRIm-Score had the highest predictive discrimination and predictive ability for early death. CONCLUSIONS: The GRIm-Score had the highest accuracy in predicting early death and OS. Clinicians may use this score to identify patients at higher risk of early death to guide treatment decisions including clinical trial enrolment. This score could also be used as a stratification factor in future clinical trial designs. Oxford University Press 2022-11-15 /pmc/articles/PMC10020804/ /pubmed/36378560 http://dx.doi.org/10.1093/oncolo/oyac235 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.
spellingShingle Gastrointestinal Cancer
Ma, Lucy X
Espin-Garcia, Osvaldo
Bach, Yvonne
Aoyama, Hiroko
Allen, Michael J
Wang, Xin
Darling, Gail E
Yeung, Jonathan
Swallow, Carol J
Brar, Savtaj
Veit-Haibach, Patrick
Kalimuthu, Sangeetha
Wong, Rebecca
Chen, Eric X
O’Kane, Grainne M
Jang, Raymond W
Elimova, Elena
Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title_full Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title_fullStr Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title_full_unstemmed Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title_short Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer
title_sort comparison of four clinical prognostic scores in patients with advanced gastric and esophageal cancer
topic Gastrointestinal Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020804/
https://www.ncbi.nlm.nih.gov/pubmed/36378560
http://dx.doi.org/10.1093/oncolo/oyac235
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