지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.6
- 수록면
- 132 - 144 (13page)
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초록· 키워드
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Purpose: To identify baseline prognostic factors for survival in patients with disease progression, during or after chemotherapy for the treatment of advanced gastric or gastroesophageal junction (GEJ) cancer.
Materials and Methods: We pooled data from patients randomized between 2009 and 2012 in 2 phase III, global double-blind studies of ramucirumab for the treatment of advanced gastric or GEJ adenocarcinoma following disease progression on first-line platinum- and/or fluoropyrimidine-containing therapy (REGARD and RAINBOW). Forty-one key baseline clinical and laboratory factors common in both studies were examined. Model building started with covariate screening using univariate Cox models (significance level=0.05). A stepwise multivariable Cox model identified the final prognostic factors (entry+exit significance level=0.01). Cox models were stratified by treatment and geographic region. The process was repeated to identify baseline prognostic quality of life (QoL) parameters.
Results: Of 1,020 randomized patients, 953 (93%) patients without any missing covariates were included in the analysis. We identified 12 independent prognostic factors of poor survival: 1) peritoneal metastases; 2) Eastern Cooperative Oncology Group (ECOG) performance score 1; 3) the presence of a primary tumor; 4) time to progression since prior therapy <6 months; 5) poor/unknown tumor differentiation; abnormally low blood levels of 6) albumin, 7) sodium, and/or 8) lymphocytes; and abnormally high blood levels of 9) neutrophils, 10) aspartate aminotransferase (AST), 11) alkaline phosphatase (ALP), and/or 12) lactate dehydrogenase (LDH). Factors were used to devise a 4-tier prognostic index (median overall survival [OS] by risk [months]: high=3.4, moderate=6.4, medium=9.9, and low=14.5; Harrell's C-index=0.66; 95% confidence interval [CI], 0.64?0.68). Addition of QoL to the model identified patient-reported appetite loss as an independent prognostic factor.
Conclusions: The identified prognostic factors and the reported prognostic index may help clinical decision-making, patient stratification, and planning of future clinical studies.
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참고문헌 (29)
참고문헌 신청
Ferlay J / 2015 / Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386
Ferlay J / GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11
Howlader N / SEER Cancer Statistics Review, 1975–2012 (based on November 2014 SEER data submission, posted to the SEER web site, April 2015)
Avital I / 2011 / DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology / Lippincott Williams & Wilkins :924~954
Koh TJ / 2002 / Sleisenger & Fordtran's Gastrointestinal and Liver Disease / Saunders :829~844
Ferlay J / GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11
Howlader N / SEER Cancer Statistics Review, 1975–2012 (based on November 2014 SEER data submission, posted to the SEER web site, April 2015)
Avital I / 2011 / DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology / Lippincott Williams & Wilkins :924~954
Koh TJ / 2002 / Sleisenger & Fordtran's Gastrointestinal and Liver Disease / Saunders :829~844
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