Prognostic significance of a systemic inflammatory response in patients receiving first-line palliative chemotherapy for recurred or metastatic gastric cancer

BMC Cancer

Research Article

Jun-Eul Hwang¹  Sung-Hoon Jung¹  Sang-Hee Cho¹  Woo-Kyun Bae¹  Ha-Na Kim¹  Hyun-Jeong Shim¹  Dae-Eun Kim¹  Ik-Joo Chung²  Hyun-Jung Choi³  Eu-Chang Hwang⁴ 

[1] Department of Internal Medicine, Division of Hemato-oncology, Chonnam National University Medical School, Gwangju, South Korea;Department of Internal Medicine, Division of Hemato-oncology, Chonnam National University Medical School, Gwangju, South Korea;Department of Internal Medicine, Chonnam National University Hwasun Hospital, 519-809, Jeollanamdo, South Korea;Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea;Department of Urology, Chonnam National University Medical School, Gwangju, South Korea;

关键词: Gastric Cancer;    Overall Survival;    Bone Metastasis;    Glasgow Prognostic Score;    Metastatic Gastric Cancer;   

DOI  :  10.1186/1471-2407-11-489

 received in 2011-07-07, accepted in 2011-11-21,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThere is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor prognosis in patients with advanced cancers. We evaluated the relationships between clinical status, laboratory factors and progression free survival (PFS), and overall survival (OS) in patients with recurrent or metastatic gastric cancer receiving first-line palliative chemotherapy.MethodsWe reviewed 402 patients with advanced gastric adenocarcinoma who received first-line palliative chemotherapy from June 2004 and December 2009. Various chemotherapy regimens were used. Eastern Cooperative Oncology Group performance status (ECOG PS), C-reactive protein (CRP), albumin, Glasgow prognostic score (GPS), and clinical factors were recorded immediately prior to first-line chemotherapy. Patients with both an elevated CRP (>1.0 mg/dL) and hypoalbuminemia (<3.5 mg/dL) were assigned a GPS of 2. Patients in whom only one of these biochemical abnormalities was present were assigned a GPS of 1, and patients with a normal CRP and albumin were assigned a score of 0. To evaluate the factors that affected PFS and OS, univariate and multivariate analyses were performed.ResultsAccording to multivariate analysis, the factors independently associated with PFS were ECOG PS (HR 1.37, 95% CI 1.02-1.84, P = 0.035), bone metastasis (HR 1.74, 95% CI 1.14-2.65, P = 0.009), and CRP elevation (HR 1.64, 95% CI 1.28-2.09, P = 0.001). The factors independently associated with OS were ECOG PS (HR 1.33, 95% CI 1.01-1.76, P = 0.037), bone metastasis (HR 1.61, 95% CI 1.08-2.39, P = 0.017), and GPS ≥ 1 (HR 1.76, 95% CI 1.41-2.19, P = 0.001).ConclusionsThe results of this study showed that the presence of a systemic inflammatory response as evidenced by the CRP, GPS was significantly associated with shorter PFS and OS in patients with recurrent or metastatic gastric cancer receiving first-line palliative chemotherapy. Bone metastasis and GPS were very useful indicator for survival in patients with recurrent or metastatic gastric cancer receiving palliative chemotherapy.

【 授权许可】

Unknown   
© Hwang et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited