title: A prognostic model to predict clinical outcome in gastric cancer patients with bone metastasis.
abstract: BACKGROUND
  The clinicopathological manifestations and treatment outcomes of bone metastasis of gastric cancer are largely unknown. We delineated a prognostic model to identify different risk groups on the basis of clinical parameters.
  
  
  METHODS
  Patients who had bone metastasis at the time of diagnosis of gastric cancer (synchronous metastasis) or who developed bone metastasis during follow-up (metachronous metastasis) were retrospectively reviewed from January 1998 to May 2008.
  
  
  RESULTS
  Bone metastasis was identified in 203 (2.4%) of 8,633 patients: 126 patients (62%) with synchronous metastasis and 77 patients with metachronous metastasis. The median time to event was 16 months (range 4-87). As for treatment, 120 patients (59%) received systemic chemotherapy. The median survival time was 103 days (95% CI 80-126). Poor performance status [Eastern Cooperative Oncology Group 3-4; relative risk (RR) = 1.91, p = 0.011], multiple bone metastasis (RR = 2.593, p = 0.002), and abnormal carcinoembryonic antigen (RR = 1.779, p = 0.004) implied independent factors for survival. For patients who had zero to two of these factors identified, chemotherapy had a beneficial effect (175 vs. 43 days; p < 0.0001).
  
  
  CONCLUSIONS
  We recommend that the therapeutic approach with bone metastasis be customized to facilitate the risk stratification, so as to consequently provide the most appropriate therapy for each patient.
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, Seoul, Korea.
authors.forename: Hyung Soon
authors.initials: HS
authors.lastname: Park
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Rha
authors.forename: Hyo Song
authors.initials: HS
authors.lastname: Kim
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Park
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Chung
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.forename: Hei-Cheul
authors.initials: HC
authors.lastname: Jeung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000097:blood / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
chemical_list: D002272:Carcinoembryonic Antigen