Evaluation of the Estimation of Physiologic Ability and Surgical Stress Score as a Prognostic Indicator for Older Patients with Gastric Cancer.


Journal

Digestive surgery
ISSN: 1421-9883
Titre abrégé: Dig Surg
Pays: Switzerland
ID NLM: 8501808

Informations de publication

Date de publication:
2020
Historique:
received: 13 09 2018
accepted: 30 01 2019
pubmed: 8 3 2019
medline: 2 12 2020
entrez: 8 3 2019
Statut: ppublish

Résumé

The incidence of gastric cancer (GC) among the older adults is increasing. Therefore, determining postoperative age-associated prognostic factors is clinically important. This present study retrospectively investigated the prognostic significance of the estimation of physiologic ability and surgical stress (E-PASS) of such patients with GC. We enrolled 136 patients aged ≥75 years with a histopathological diagnosis of gastric adenocarcinoma who underwent gastrectomy. Receiver operating characteristic curves were generated to evaluate survival, and AUC values were compared to assess the discriminatory ability of carcinoembryonic antigen, the perioperative risk score, the surgical stress score, and the comprehensive risk score (CRS) of E-PASS. The AUC value of CRS was of the highest AUC value as a function of overall survival (OS) and disease-specific survival. The 5-year OS rates of CRSHigh and CRSLow groups were 50.6 and 76.9% (p = 0.0007) respectively. The 5-year DSS rates of the CRSHigh and CRSLow groups were 78.8 and 95.2% (p = 0.028) respectively. Further, the 5-year survival rates unrelated to cancer of the CRSHigh and CRSLow groups were 64.2 and 80.9% (p = 0.0096) respectively. Multivariate analysis identified that CRS was an independent prognostic indicator. E-PASS was a useful prognostic indicator for older GC patients.

Sections du résumé

BACKGROUND BACKGROUND
The incidence of gastric cancer (GC) among the older adults is increasing. Therefore, determining postoperative age-associated prognostic factors is clinically important. This present study retrospectively investigated the prognostic significance of the estimation of physiologic ability and surgical stress (E-PASS) of such patients with GC.
METHODS METHODS
We enrolled 136 patients aged ≥75 years with a histopathological diagnosis of gastric adenocarcinoma who underwent gastrectomy.
RESULTS RESULTS
Receiver operating characteristic curves were generated to evaluate survival, and AUC values were compared to assess the discriminatory ability of carcinoembryonic antigen, the perioperative risk score, the surgical stress score, and the comprehensive risk score (CRS) of E-PASS. The AUC value of CRS was of the highest AUC value as a function of overall survival (OS) and disease-specific survival. The 5-year OS rates of CRSHigh and CRSLow groups were 50.6 and 76.9% (p = 0.0007) respectively. The 5-year DSS rates of the CRSHigh and CRSLow groups were 78.8 and 95.2% (p = 0.028) respectively. Further, the 5-year survival rates unrelated to cancer of the CRSHigh and CRSLow groups were 64.2 and 80.9% (p = 0.0096) respectively. Multivariate analysis identified that CRS was an independent prognostic indicator.
CONCLUSIONS CONCLUSIONS
E-PASS was a useful prognostic indicator for older GC patients.

Identifiants

pubmed: 30844794
pii: 000497457
doi: 10.1159/000497457
doi:

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

171-178

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Yuki Murakami (Y)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Hiroaki Saito (H)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan, sai10@med.tottori-u.ac.jp.

Shota Shimizu (S)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Yusuke Kono (Y)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Yuji Shishido (Y)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Kozo Miyatani (K)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Tomoyuki Matsunaga (T)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Yoji Fukumoto (Y)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Keigo Ashida (K)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

Yoshiyuki Fujiwara (Y)

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

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