Faculty, Staff and Student Publications
Publication Date
3-17-2023
Journal
The Oncologist
DOI
10.1093/oncolo/oyac235
PMID
36378560
PMCID
PMC10020804
PubMedCentral® Posted Date
11-15-2022
PubMedCentral® Full Text Version
Post-print
Abstract
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.
Keywords
Humans, Esophageal Neoplasms, Prognosis, Proportional Hazards Models, Retrospective Studies, Stomach Neoplasms, Treatment Outcome
Published Open-Access
yes
Recommended Citation
Ma, Lucy X; Espin-Garcia, Osvaldo; Bach, Yvonne; et al., "Comparison of Four Clinical Prognostic Scores in Patients with Advanced Gastric and Esophageal Cancer" (2023). Faculty, Staff and Student Publications. 5089.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5089
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Genetic Phenomena Commons, Medical Genetics Commons, Oncology Commons