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

• Published in: Oncology Vol. 80; no. 1-2; pp. 142 - 150
• Main Authors: Park, Hyung Soon, Rha, Sun Young, Kim, Hyo Song, Hyung, Woo Jin, Park, Ji Soo, Chung, Hyun Cheol, Noh, Sung Hoon, Jeung, Hei-Cheul
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.06.2011; S. Karger AG
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone cancer; Bone Neoplasms - blood; Bone Neoplasms - pathology; Bone Neoplasms - secondary; Bone Neoplasms - therapy; Bones; Cancer; Carcinoembryonic antigen; Carcinoembryonic Antigen - blood; Chemotherapy; Clinical outcomes; Clinical Study; Female; Gastric cancer; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Kaplan-Meier Estimate; Liver Neoplasms - secondary; Lung Neoplasms - secondary; Male; Medical prognosis; Medical sciences; Metastases; Metastasis; Middle Aged; Oncology; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk assessment; Risk Factors; Risk groups; Stomach; Stomach Neoplasms - blood; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival; Survival Rate; Time Factors; Tumors; Young Adult; Prognostic factor; Gastric cancer; Bone metastasis; Human; Prognosis; Diseases of the osteoarticular system; Malignant tumor; Stomach cancer; Bone cancer; Cancerology; Gastric metastasis; Digestive diseases; Models; Predictive factor; Cancer; Gastric disease
• ISSN: 0030-2414; 1423-0232
• DOI: 10.1159/000328507

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.