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Original article

Vol. 141 No. 3334 (2011)

Survival predictors for second-line chemotherapy in Caucasian patients with metastatic gastric cancer

  • P Bohanes
  • P Morel
  • O Huber
  • DS Courvoisier
  • TV Perneger
  • AD Roth
DOI
https://doi.org/10.4414/smw.2011.13249
Cite this as:
Swiss Med Wkly. 2011;141:w13249
Published
15.08.2011

Abstract

PRINCIPLES: There are very limited data suggesting a benefit for second-line chemotherapy in advanced gastric cancer. Therefore, the number of patients who receive further treatment after failure of first-line chemotherapy varies considerably, ranging from 14% to 75%. In the absence of a demonstrated survival benefit of second-line chemotherapy, appropriate selection of patients based on survival predictors is essential. However, no clinico-pathologic parameters are currently widely adopted in clinical practice. We looked exclusively at Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy to see if we could establish prognostic factors for survival.

METHODS: This study retrospectively evaluated 43 Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy at the Geneva University Hospital. Prognostic values of clinico-pathologic parameters were analysed by Cox regression for overall survival (OS).

RESULTS:Univariate analysis found three variables to be associated with survival: progression-free survival (PFS) at first-line chemotherapy of more than 26 weeks (hazard ratio (HR) = 0.33, confidence interval (CI) 95% 0.16–0.65, p = 0.002), previous curative surgery (HR = 0.51, CI 95% 0.27–0.96, p = 0.04) and carcinoma embryonic antigen (CEA) >6.5 μg/l (HR = 1.97, CI 95% 1.06–3.65, p = 0.03).

CONCLUSIONS: In line with published data, sensitivity to previous chemotherapy identifies Caucasian patients who will survive the longest following second-line chemotherapy. A low tumour burden and previous curative gastrectomy also seem to have a positive prognostic value.

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