Weight loss at the first month of palliative chemotherapy predicts survival outcomes in patients with advanced gastric cancer.
BACKGROUND
Weight loss during chemotherapy is a significant prognostic factor for poor survival in patients with advanced gastric cancer (AGC). However, in most studies, weight loss was measured at the end of chemotherapy, limiting its clinical use. In this study, we evaluated whether weight loss during the first month of chemotherapy could predict survival outcomes in patients with AGC.


METHODS
We analyzed 719 patients with metastatic or recurrent AGC who were receiving palliative chemotherapy. We calculated the initial body mass index (BMIi), percent weight loss after 1 month of chemotherapy (ΔW 1m), percent weight loss after last administration of chemotherapy (ΔW end), and average weight loss per month during chemotherapy (ΔW/m). We correlated these data with overall survival (OS) by receiver-operating characteristic (ROC) curves and Kaplan-Meier curves, and performed a subgroup analysis using Cox regression.


RESULTS
The probabilities of longer OS had stronger correlations with ΔW/m and ΔW 1m than with ΔW end or BMIi. A significant positive correlation between ΔW 1m and ΔW/m (r (2) = 0.591, p < 0.001) was observed. Median OS of patients with ΔW 1m more than 3 % was significantly shorter than in patients with less weight loss (OS: 9.7 vs. 16.3 months, p < 0.001). Subgroup analysis revealed that ΔW 1m accompanied poor survival irrespective of other clinical characteristics.


CONCLUSIONS
Weight loss at the very first month of palliative chemotherapy could predict unfavorable survival outcomes in AGC.
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
Chan-Young
CY
Ock
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. ohdoyoun@snu.ac.kr.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ohdoyoun@snu.ac.kr.
Do-Youn
DY
Oh
Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.
Joongyub
J
Lee
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Tae-Yong
TY
Kim
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Kyung-Hun
KH
Lee
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Sae-Won
SW
Han
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Seock-Ah
SA
Im
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Tae-You
TY
Kim
Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Yung-Jue
YJ
Bang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D015431:Weight Loss / Q000187:drug effects*; D055815:Young Adult
Chemotherapy; Gastric cancer; Prognostic factor; Survival; Weight loss