title: MELD-sodium score and its prognostic value in malignancy-related ascites of pancreatic and gastric cancer.
abstract: BACKGROUND
  Malignant ascites is a manifestation of end-stage events in a variety of cancers. There is significant lack of possible survival predictors in patients with malignancy-related ascites. Since the Model for End-Stage Liver Disease (MELD)-Na score has been shown to be a feasible and independent prognostic predictor for both short- and long-term outcome in HCC patients, we decided to test its prognostic role in other cancer types with ascites.
  
  
  METHODS
  This is a retrospective study. The outpatient oncology clinic's records were screened for the period between 2004 and 2011. Eighty-two pancreatic and gastric cancer patients were enrolled into the study.
  
  
  RESULTS
  The median age of patients was 59 (±12). Fifty-nine patients had gastric cancer and 23 had pancreatic cancer. Overall survival (OS) was 16.8 (IR, 1-98) months in gastric cancer and 16.3 (IR, 0.5-81) months in pancreatic cancer. There was no statistically significant difference between OS of gastric and pancreatic cancer. Progression-free survival (PFS) was statistically significantly longer in gastric cancer than pancreatic cancer with 16.5 (IR, 0.5-90) vs 6.5 (IR, 0.4-34) months (P = 0.04). Further analysis of data included stepwise multiple regression analysis with the dependent variable "overall survival." The model had two independent predictors and an R(2) of 82 % and a predicted R(2) of 81 %. Predictors for time to remission were PFS and MELD-Na. The regression equation for the model was: Overall survival =17.4- 0.522 MELD-Na + 0.902 PFS CONCLUSION: In this study we showed that progression-free survival and MELD-Na score are significantly related with overall survival. MELD-Na score can be one of the predictors of the survival and PFS in pancreatic and gastric cancer patients with ascites.
authors.affiliation: Department of Internal Medicine, School of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Engin
authors.forename: Cemil
authors.initials: C
authors.lastname: Bilir
authors.forename: Yücel
authors.initials: Y
authors.lastname: Ustündağ
mesh_terms: D000368:Aged; D001201:Ascites / Q000188:drug therapy / Q000209:etiology / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000401:mortality; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000401:mortality*; D014421:Turkey
chemical_list: D015415:Biomarkers