Cristina Díaz Del Arco1, Lourdes Estrada Muñoz2, Luis Ortega Medina3, Ángela Chávez4, Irene Ruiz Adelantado5, Soledad García Gómez de Las Heras6, M Jesús Fernández Aceñero7. 1. Complutense University of Madrid, Av. Séneca 2, 28040 Madrid, Spain; Hospital Clínico San Carlos, c/Profesor Martín Lagos s/n, 28040 Madrid, Spain. Electronic address: crisdelarco@gmail.com. 2. Rey Juan Carlos University of Madrid, Av. De Atenas s/n, 28922 Alcorcón, Madrid, Spain; Rey Juan Carlos Hospital, c/ Gladiolo s/n, 28933 Móstoles, Mardrid, Spain. 3. Complutense University of Madrid, Av. Séneca 2, 28040 Madrid, Spain; Hospital Clínico San Carlos, c/Profesor Martín Lagos s/n, 28040 Madrid, Spain. 4. Autónoma University of Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain. 5. Hospital Clínico San Carlos, c/Profesor Martín Lagos s/n, 28040 Madrid, Spain. 6. Rey Juan Carlos University of Madrid, Av. De Atenas s/n, 28922 Alcorcón, Madrid, Spain. 7. Complutense University of Madrid, Av. Séneca 2, 28040 Madrid, Spain; Hospital General Universitario Gregorio Marañón, c/ Dr. Esquerdo no. 46, 28007 Madrid, Spain.
Abstract
INTRODUCTION: Gastric cancer (GC) is a multifactorial disease. Several prognostic scores have been proposed for refining the prognostic information provided by the TNM classification. Our aim is to validate and compare the prognostic performance of different clinicopathological scores in a western cohort of patients (Marubini, Haraguchi and Kologlu scores). MATERIAL AND METHODS: Retrospective study of all cases of GC resected in a western tertiary center (N = 377). Clinicopathological features were collected, scores were applied and statistical analyses were performed. RESULTS: 315 cases were finally included. According to Marubini, Haraguchi and Kologlu scores, patients were stage I (18.5%, 13.3% and 49%), II (29.3%, 47.2% and 29.5%) and III (52.2%, 39.5% and 21.5%, respectively). All classifications were significantly associated with lymphovascular invasion, perineural infiltration, lymph node involvement, patient progression and death due to GC. All scores showed good patient stratification by Kaplan-Meier analyses, but OS and DFS curves depending on Haraguchi score were less evenly spaced. Kologlu classification showed prognostic superiority over Haraguchi and Marubini classifications by ROC analysis. AUC values for OS and DFS were 0.654 and 0.647 (Marubini), 0.626 and 0.618 (Haraguchi) and 0.724 and 0.709 (Kologlu). Kologlu and Marubini classifications were independent factors for both OS and DFS, but Haraguchi classification was independently associated only with DFS. CONCLUSIONS: Clinicopathological scores can be easily validated and are cost-effective. Kologlu score is the most thorough classification, and it showed the best prognostic performance for both DFS and OS in our study. More studies are needed to validate its value in other populations.
INTRODUCTION:Gastric cancer (GC) is a multifactorial disease. Several prognostic scores have been proposed for refining the prognostic information provided by the TNM classification. Our aim is to validate and compare the prognostic performance of different clinicopathological scores in a western cohort of patients (Marubini, Haraguchi and Kologlu scores). MATERIAL AND METHODS: Retrospective study of all cases of GC resected in a western tertiary center (N = 377). Clinicopathological features were collected, scores were applied and statistical analyses were performed. RESULTS: 315 cases were finally included. According to Marubini, Haraguchi and Kologlu scores, patients were stage I (18.5%, 13.3% and 49%), II (29.3%, 47.2% and 29.5%) and III (52.2%, 39.5% and 21.5%, respectively). All classifications were significantly associated with lymphovascular invasion, perineural infiltration, lymph node involvement, patient progression and death due to GC. All scores showed good patient stratification by Kaplan-Meier analyses, but OS and DFS curves depending on Haraguchi score were less evenly spaced. Kologlu classification showed prognostic superiority over Haraguchi and Marubini classifications by ROC analysis. AUC values for OS and DFS were 0.654 and 0.647 (Marubini), 0.626 and 0.618 (Haraguchi) and 0.724 and 0.709 (Kologlu). Kologlu and Marubini classifications were independent factors for both OS and DFS, but Haraguchi classification was independently associated only with DFS. CONCLUSIONS: Clinicopathological scores can be easily validated and are cost-effective. Kologlu score is the most thorough classification, and it showed the best prognostic performance for both DFS and OS in our study. More studies are needed to validate its value in other populations.
Authors: Cristina Díaz Del Arco; Lourdes Estrada Muñoz; Luis Ortega Medina; Elena Molina Roldán; M Ángeles Cerón Nieto; Soledad García Gómez de Las Heras; M Jesús Fernández Aceñero Journal: World J Gastrointest Oncol Date: 2022-06-15