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D A C Deans, S J Wigmore, A C de Beaux, S Paterson-Brown, O J Garden, K C H Fearon, Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer, British Journal of Surgery, Volume 94, Issue 12, December 2007, Pages 1501–1508, https://doi.org/10.1002/bjs.5849
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Abstract
Accurate prediction of prognosis in gastro-oesophageal cancer remains challenging. The aim of this study was to develop a robust model for outcome prediction.
The study included 220 patients with gastric or oesophageal cancer newly diagnosed over a 2-year period. Patients were staged and underwent treatment following discussion at a multidisciplinary team (MDT) meeting. Clinical and investigative variables were collected, including performance and nutritional status, and serum C-reactive protein (CRP) level. Primary endpoints were death within 12 and 24 months.
Overall median survival was 13 months. Advanced clinical stage (P < 0·001), reduced performance score (P < 0·001), weight loss exceeding 2·75 per cent per month (P = 0·026) and serum CRP concentration above 5 mg/l (P = 0·031) were identified as independent prognostic indicators in multivariable analysis. A prognostic score was constructed using these four variables to estimate a probability of death. Applying the model gave an area under the receiver–operator characteristic curve of 0·84 and 0·85 for prediction of death at 12 and 24 months respectively (both P < 0·001).
This model accurately estimated the probability of death within 12 and 24 months. This may aid the MDT decision-making process.