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Clinical Prognostic Factors in Gastric Cancer in Chinese Patients:

Clinical Prognostic Factors in Gastric Cancer in Chinese Patients: Experience from the Cancer Hospital/Institute, Chinese Academy of Medical Sciences. Yuankai Shi, M.D. Department of Medical Oncology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences (CAMS). Background.

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Clinical Prognostic Factors in Gastric Cancer in Chinese Patients:

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  1. Clinical Prognostic Factors in Gastric Cancer in Chinese Patients: Experience from the Cancer Hospital/Institute, Chinese Academy of Medical Sciences Yuankai Shi, M.D. Department of Medical Oncology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences (CAMS)

  2. Background Gastric cancer worldwidein 2002: 4th most common cancer, 2nd most common cause of death, 2/3 patients in developing countries, 42% of them in China Parkin DM, et al. CA Cancer J Clin. 2005;55:74

  3. 5-year overall survival: 15%-54% Parkin DM, et al. CA Cancer J Clin. 2005;55:74

  4. Gastric cancer in China in 2005 • Incidence: 376,000 new cases Third most common cancer • Mortality: 24.71/105 Third cause of death from cancer Behind Lung cancer and Liver cancer http://www.moh.gov.cn

  5. Objective • To evaluate the therapeutic effects and prognostic factors in patients with operable gastric cancer • To construct a prognostic model

  6. Materials and methods • Identify prognostic factors with data from 1043 pts treated with combined modality therapy based on gastrectomy, between 1999 and 2002, in the Cancer Hospital, CAMS • Construct prognostic model with data from 1284 pts with combined modality treatment based on gastrectomy, between 1999-2006, in the Cancer Hospital, CAMS • Statistical analysis Life Table, Cox hazard proportional model, Logistic regression model

  7. Results 5-year 39% 15% 1043 pts with operable gastric cancer • Median survival: 39.5 mo • median relapse-free survival: 22.7 mo • 5-y OS: 39% • 5-y RFS: 15% 5-year OS 100% 91% 84% 61% 33% 19% 5% median follow-up: 51.6 mo

  8. Univariate analysis in 1043 pts

  9. Univariate analysis in 1043 pts

  10. Independent prognostic factors

  11. Training sample n=963 Construct Prognostic equation Prognostic index All pts n=1284 Randomized Prognostic model Testing sample n=321 Validate

  12. Overall survival and relapse-free survival Median follow-up: 35.7 mo 5-y OS: 40% 5-y RFS: 12% Fig.Overall survival (OS) and relapse-free survival (RFS) for 1284 patients.

  13. Univariate analysis in 1284 pts

  14. Univariate analysis in 1284 pts

  15. Independent prognostic factors of OS in training sample

  16. Prognostic model LNM: Lymphonode metastases; PCI: peritoneal cavity involvement.

  17. Risk model defined by prognostic index

  18. 5-y OS 81% 48% 20% 0 P<0.001 5-year OS 82% 60% 27% 7% 5-y OS 82% 60% 27% 7% P<0.001 Risk model in age group

  19. Risk model in stage

  20. Survival curve according to risk model L LI L LI

  21. Risk model in treatment

  22. Discussion Lagarde SM, et al. J Clin Oncol, 2006, 24:4347

  23. Comparison in gastric cancer prognostic factors Zhan YQ, et al. Ai Zheng 2005,24:596; Yokota T, et al. Anticancer Res 2002,22:3673; Schwarz RE et al. Ann Surg Oncol 2007,14:317

  24. Conclusion • This risk model could identify various outcomes in pts with the same stage from IB to IV • This risk model also could identify different outcomes in pts with the same treatment status • Prospective study are warranted to validate these findings.

  25. Dept. of Abdominal Surgical Oncology Zhi-xiang Zhou Hai-zeng Zhang Yi Shan Ping Zhao Xiang Wang Jian-xiong Wu Yong-fu Zhao Dept. of Medical Oncology Jing Wang Jin-wan Wang Hong-gang Zhang Yu-sheng Li Jing Huang Xiao-hui He Xiao-hong Han Dept. of Pathology Xun Zhang Yan Song Shang-mei Liu Dept. of Imaging Diagnosis Chun-wu Zhou Li-ming Jiang Zhu Wang Acknowledgements

  26. Thank you for your attention!

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