A Prognostic Model to Predict Clinical Outcome in Gastric Cancer Patients with Bone Metastasis

Abstract

Background: The clinicopathological manifestations and treatment outcomes of bone metastasis of gastric cancer are largely unknown. We delineated a prognostic model to identify different risk groups on the basis of clinical parameters. Methods: Patients who had bone metastasis at the time of diagnosis of gastric cancer (synchronous metastasis) or who developed bone metastasis during follow-up (metachronous metastasis) were retrospectively reviewed from January 1998 to May 2008. Results: Bone metastasis was identified in 203 (2.4%) of 8,633 patients: 126 patients (62%) with synchronous metastasis and 77 patients with metachronous metastasis. The median time to event was 16 months (range 4–87). As for treatment, 120 patients (59%) received systemic chemotherapy. The median survival time was 103 days (95% CI 80–126). Poor performance status [Eastern Cooperative Oncology Group 3–4; relative risk (RR) = 1.91, p = 0.011], multiple bone metastasis (RR = 2.593, p = 0.002), and abnormal carcinoembryonic antigen (RR = 1.779, p = 0.004) implied independent factors for survival. For patients who had zero to two of these factors identified, chemotherapy had a beneficial effect (175 vs. 43 days; p < 0.0001). Conclusion: We recommend that the therapeutic approach with bone metastasis be customized to facilitate the risk stratification, so as to consequently provide the most appropriate therapy for each patient.

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

“…The preoperative ECOG performance status was also included in the model but only scarce literature is available on the role of ECOG performance status and its impact on the risk of surgical adverse events in endometrial cancer. However, performance status has been shown to be related to clinical outcomes including survival in other cancers (18)(19)(20)(21)(22)(23)(24).…”

Pancytopenia and Isolated Bone Marrow Recurrence in a Case of Previously Resected Gastric Carcinoma: A Rare Finding

“…Prognostic factors for poor survival are low performance status, multiple bone metastases, and elevated tumor markers. Patients with fewer than two of those adverse prognostic factors benefited from palliative chemotherapy [8]. The present case have isolated bone marrow metastasis and raised CA 19-9.…”

“…Gastric cancer cases with bone marrow involvement have very poor prognosis with a survival period ranging from 1.5 to 4 months [8,9]. Prognostic factors for poor survival are low performance status, multiple bone metastases, and elevated tumor markers.…”

First-Line Chemotherapy for Metastatic Esophageal Squamous Cell Carcinoma: Clinico-Biological Predictors of Disease Control

“…The presence of bone metastases is associated with poor prognosis in some cancers, such as lung adenocarcinoma, gastric adenocarcinoma, hepatocellular carcinoma and ovarian carcinoma [16,17,18,19,20]. In a large series of 360 patients with MESCC, 7% were found to have bone metastases, against 16 and 13% in both of our cohorts [21].…”