Korean gastric cancer prognostic tool accurate in U.S. patients

Reuters Health Information: Korean gastric cancer prognostic tool accurate in U.S. patients

Korean gastric cancer prognostic tool accurate in U.S. patients

Last Updated: 2018-01-09

By Reuters Staff

NEW YORK (Reuters Health) - The Yonsei University Gastric Cancer Prediction Model accurately predicts 5-year overall survival in U.S. gastric cancer patients, according to a validation study.

An international collaborative group developed this prediction model using data from Korean gastric cancer patients and validated it using data sets from East Asia, but the model had not yet been tested in an equivalent Western population.

In the current study, Dr. Woo Jin Hyung from Yonsei University College of Medicine, Seoul, South Korea, and colleagues used data from the Surveillance, Epidemiology, and End Results (SEER) program of the U.S. National Cancer Institute to assess the new model's accuracy and to compare it with the TNM (tumor-node-metastasis) staging system prognostic index.

The researchers identified 15,483 patients with gastric adenocarcinoma. Their ages ranged from 20 to 101 (mean, 65.5) and averaged 9.6 years older than the Korean group. The findings were reported online December 22 in the Journal of the American College of Surgeons.

Compared with Korean patients, fewer U.S. patients had stage 1 disease (8.2% vs. 47.1%) and more U.S. patients had M0 disease with lymph node dissections that were inadequate for proper staging (52.1% vs. 2.4%).

Despite these and other differences, the predictive accuracy of the Yonsei University Gastric Cancer Prediction Model was 76.2% in this population, significantly better than that of the TNM staging system 7th edition (70.4%) and consistent with the findings of the original study.

"While more accurate for survival than the TNM staging system and more inclusive than other nomograms, Yonsei University gastric cancer prediction tool's limitation is that much like the other clinical nomograms, these tools only account for patients who have undergone surgery," the researchers caution. "Additionally, majority of the gastric cancer patients outside of South Korea and Japan present with advanced gastric cancer will require multimodality treatments, and the impact of chemotherapy, radiation therapy, or targeted therapy will need to be accounted for to improve the accuracy of future prediction models."

"A globally applicable prediction tool which can provide accurate gastric cancer prognosis remains paramount in the care of gastric cancer patients worldwide," they conclude.

Dr. Hyung did not respond to a request for comment.

SOURCE: http://bit.ly/2m5GQeb

J Am Coll Surg 2017.

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