Comparison of pre-treatment clinical prognostic factors in patients with gastro-oesophageal cancer and proposal of a new staging system

Crumley, A.B.C., Stuart, R.C., McKernan, M., Going, J.J., Shearer, C.J. and McMillan, D.C. (2010) Comparison of pre-treatment clinical prognostic factors in patients with gastro-oesophageal cancer and proposal of a new staging system. Journal of Gastrointestinal Surgery, 14(5), pp. 781-787. (doi:10.1007/s11605-010-1162-6)

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Abstract

Clinical staging in patients with gastro-oesophageal cancer, is of crucial importance in determining the likely benefit of treatment. Despite recent advances in clinical staging, overall survival remains poor. The aim of the present study was to examine the relationship between pre-treatment clinical prognostic factors and cancer-specific survival. Two hundred and seventeen patients, undergoing staging investigations including host factors (Edinburgh Clinical Risk Score (ECRS)) and the systemic inflammatory response (Glasgow Prognostic score (mGPS)), in the upper GI surgical unit at Glasgow Royal Infirmary, were studied. During the follow-up period, 188 (87%) patients died; 178 of these patients died from the disease. The minimum follow-up was 46 months, and the median follow-up of the survivors was 65 months. On multivariate survival analysis of the significant factors, only cTNM stage (HR 1.84, 95% CI 1.56-2.17, p < 0.001), mGPS (HR 1.67, 95% CI 1.35-2.07, p < 0.001) and treatment (HR 2.12, 95% CI 1.73-2.60, p < 0.001) were independently associated with survival. An elevated mGPS was associated with advanced cTNM stage, poor performance status, an elevated ECRS and more conservative treatment. Pre-treatment mGPS improves clinical staging in patients with gastro-oesophageal cancer. Therefore, it is likely to aid clinical decision making for these difficult to treat patients

Item Type:Articles
Keywords:advances C-REACTIVE PROTEIN CACHEXIA CANCER DECISION DISEASE FOLLOW-UP GASTRIC-CARCINOMA Gastro-oesophageal cancer inflammation PATIENT patients PERFORMANCE Pre-operative clinical stage PROGNOSTIC-FACTORS RISK RISK SCORE SCORE Scotland SURGERY SURVIVAL SYSTEM Treatment
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMillan, Professor Donald and Going, Dr James
Authors: Crumley, A.B.C., Stuart, R.C., McKernan, M., Going, J.J., Shearer, C.J., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Journal of Gastrointestinal Surgery
Publisher:Springer
ISSN:1091-255X
Published Online:11 February 2010

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