This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Clinical prognostic scoring system to aid decision‐making in gastro‐oesophageal cancer. BJS 2007; 94: 1501-1508.
Published: 17th August 2007
Authors: D. A. C. Deans, S. J. Wigmore, A. C. de Beaux, S. Paterson‐Brown, O. J. Garden, K. C. H. Fearon et al.
Background
Accurate prediction of prognosis in gastro‐oesophageal cancer remains challenging. The aim of this study was to develop a robust model for outcome prediction.
Method
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.
Results
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).
Conclusion
This model accurately estimated the probability of death within 12 and 24 months. This may aid the MDT decision‐making process. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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