Prognostic factors in advanced gastrointestinal cancer patients with weight loss.
There are few reports on factors that determine survival in advanced gastrointestinal cancer with weight loss. In these patients (n = 91, median weight loss 16.6%), we prospectively examined the importance of metastatic spread, anthropometry, blood parameters, Karnofsky performance status, appetite, and the acute-phase response as predictors of survival. Survival was calculated from date of assessment to the most recent clinic attendance (> or = 30 mo) or until death. On multivariate analysis, metastatic spread (p < 0.05), Karnofsky performance status (p < 0.01), and C-reactive protein concentration (p < 0.001) had independent prognostic value. In locally advanced disease (n = 64), Karnofsky performance status and C-reactive protein concentration remained significant. There was a significantly lower survival in patients with an acute-phase response (median 136 days) than in patients with no response (median 466 days; p < 0.01). Performance status and the acute-phase response are associated, independent of weight loss, with survival duration in advanced gastrointestinal cancer patients.
O'Gorman
P
P
University Department of Surgery, Royal Infirmary, Glasgow, UK. patricia.o'gorman@northglasgow.scot.nhs.uk
McMillan
D C
DC
McArdle
C S
CS
D000210:Acute-Phase Reaction / Q000401:mortality*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000886:Anthropometry; D001066:Appetite; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality* / Q000503:physiopathology / Q000556:secondary; D006801:Humans; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D015431:Weight Loss
D002097:C-Reactive Protein