Clinical Prognostic Factors in Gastric Cancer in Chinese Patients:

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Clinical Prognostic Factors in Gastric Cancer in
Chinese Patients Experience from the Cancer
Hospital/Institute, Chinese Academy of Medical
Sciences
Yuankai Shi, M.D.
Department of Medical Oncology, Cancer
Hospital/Institute, Chinese Academy of Medical
Sciences (CAMS)
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Background
Gastric cancer worldwide in 2002
4th most common cancer, 2nd most common cause of
death, 2/3 patients in developing countries, 42
of them in China
Parkin DM, et al. CA Cancer J Clin. 20055574
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5-year overall survival 15-54
Parkin DM, et al. CA Cancer J Clin. 20055574
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Gastric cancer in China in 2005

• Incidence
• 376,000 new cases
• Third most common cancer
• Mortality
• 24.71/105
• Third cause of death from cancer
• Behind Lung cancer and Liver cancer

http//www.moh.gov.cn
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Objective

• To evaluate the therapeutic effects and
  prognostic factors in patients with operable
  gastric cancer
• To construct a prognostic model

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Materials and methods

• Identify prognostic factors with data from 1043
  pts treated with combined modality therapy based
  on gastrectomy, between 1999 and 2002, in the
  Cancer Hospital, CAMS
• Construct prognostic model with data from 1284
  pts with combined modality treatment based on
  gastrectomy, between 1999-2006, in the Cancer
  Hospital, CAMS
• Statistical analysis
• Life Table, Cox hazard proportional model,
  Logistic regression model

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Results
5-year 39 15
1043 pts with operable gastric cancer

• Median survival 39.5 mo
• median relapse-free survival 22.7 mo
• 5-y OS 39
• 5-y RFS 15

5-year OS 100 91 84 61 33 19 5
median follow-up 51.6 mo
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Univariate analysis in 1043 pts

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Univariate analysis in 1043 pts
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Independent prognostic factors

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Training sample n963
Prognostic equation Prognostic index
Construct
All pts n1284
Randomized
Prognostic model
Testing sample n321
Validate
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Overall survival and relapse-free survival
Median follow-up 35.7 mo 5-y OS 40 5-y RFS
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Fig. Overall survival (OS) and relapse-free
survival (RFS) for 1284 patients.
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Univariate analysis in 1284 pts

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Univariate analysis in 1284 pts

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Independent prognostic factors of OS in training
sample

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Prognostic model
LNM Lymphonode metastases PCI peritoneal
cavity involvement.
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Risk model defined by prognostic index
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Risk model in age group
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Risk model in stage
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Survival curve according to risk model
L
LI
L
LI
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Risk model in treatment
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Discussion
Lagarde SM, et al. J Clin Oncol, 2006, 244347
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Comparison in gastric cancer prognostic factors
Zhan YQ, et al. Ai Zheng 2005,24596 Yokota T,
et al. Anticancer Res 2002,223673 Schwarz RE
et al. Ann Surg Oncol 2007,14317
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Conclusion

• This risk model could identify various outcomes
  in pts with the same stage from IB to IV
• This risk model also could identify different
  outcomes in pts with the same treatment status
• Prospective study are warranted to validate these
  findings.

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Acknowledgements

• Dept. of Abdominal Surgical Oncology
• Zhi-xiang Zhou
• Hai-zeng Zhang
• Yi Shan
• Ping Zhao
• Xiang Wang
• Jian-xiong Wu
• Yong-fu Zhao
• Dept. of Medical Oncology
• Jing Wang
• Jin-wan Wang
• Hong-gang Zhang
• Yu-sheng Li
• Jing Huang
• Xiao-hui He
• Xiao-hong Han

• Dept. of Pathology
• Xun Zhang
• Yan Song
• Shang-mei Liu
• Dept. of Imaging Diagnosis
• Chun-wu Zhou
• Li-ming Jiang
• Zhu Wang

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Thank you for your attention!