In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e15557-e15557
Abstract:
e15557 Background: Preoperative radiotherapy (Pre-RT) tends to be more frequently used for advanced gastric cardia cancer (GCC) patients. However, the prognostic values of postoperative pathologic characteristics in these patients remain unclear. This study aimed to examine the outcomes in GCC patients receiving Pre-RT to identify the predictive factors for cancer-specific survival (CSS) and overall survival (OS). Methods: A total of 1818 GCC patients undergoing Pre-RT, recorded in the Surveillance Epidemiology and End Results database from 1998-2013, were reviewed. Results: Univariate analyses showed that grade, histology type, positive lymph node (PLN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) classifications significantly correlated with CSS and OS. However, through the four-step multivariate analyses, only grade and LODDS were demonstrated as the final independent risk factors for survival. Next, by combining grade with lymph node status variables, we established three novel staging models namely the grade-PLN (G-P), grade-LNR (G-R), and grade-LODDS (G-L) stages. Similarly, subsequent four-step multivariate analyses also revealed that only G-L predicted CSS and OS independently. Moreover, the new G-L staging system also validated to have better discriminatory ability, monotonicity, and homogeneity for prognostic stratification, as well as a more-accurate 3-year CSS (P = 0.023) and OS (P = 0.015) prediction than AJCC staging system. Conclusions: The G-L staging system was superior in determining the prognosis of GCC patients after Pre-RT. Further large-scale prospective cohort analyses are warranted.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.e15557
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
