Retrospective Study
Copyright ©The Author(s) 2019.
World J Gastrointest Oncol. Jan 15, 2019; 11(1): 28-38
Published online Jan 15, 2019. doi: 10.4251/wjgo.v11.i1.28
Table 1 Characteristics of patients with advanced gastric cancer
CharacteristicsTotalEarly WTElective WTP value
No.1104664
Disease status Unresectable/ recurrent103/743/360/41.000
Waiting time (WT), d, median (IQR)17 (12.5, 26)10 (7, 13)24 (19. 36)P < 0.0001
Male sex, n, %79, 72%34, 74%45, 70%0.6743
Age, yr, median (IQR)70 (64, 78)71 (64, 80)67 (62, 75)0.1490
BMI, median (IQR)20.3 (18.6, 22.8)21.1 (19.0, 22.8)19.9 (18.4, 22.9)0.5298
Diabetes mellitus, n, %15, 14%5, 11%10, 17%0.4158
Hypertension, n, %36, 35%16, 36%20, 34%1.000
Dementia, n, %2, 2%1, 2.2%1, 1.7%1.000
Chronic kidney disease, n, %43, 41%19, 42%24, 40%0.8434
Charlson comorbidity index, median (IQR)0 (0, 1)0 (0, 0.5)0 (0, 1)0.3884
Low/medium/high/missing73 (70%)/29 (28%)/3 (3%), 5(5%)34/9/2/139/20/1/4
PS 0-1, n, %95, 86%41, 89%54, 84%0.8234
Histology type, intestinal n, %40, 36%18, 39%22, 35%0.5228
HER 2 IHC 3+< or FISH (+), n, %26, 26%12, 26%14, 22%0.6080
Gastric cardia tumor site, n, %25, 23%7, 15%18, 29%0.1130
Target lesion, n, %91, 91%41, 91%50, 91%1.000
No. of metastatic lesions ≤ 1, %39, 35%16, 35%23, 36%1.000
CEA, median (IQR)6.5 (2.2, 40.9)6.5 (2.4, 80)5.7 (2, 25)0.4624
CA19-9, median (IQR)22 (5, 810)54.5 (4.5, 2289)17 (5, 630)0.7326
Hb, g/dL, median (IQR)11.3 (9.2, 12.7)11.3 (9.3, 12.9)11.2 (9.1, 12.7)0.8995
Alb, g/dL, median (IQR)3.3 (3, 3.7)3.2 (2.8, 3.5)3.4 (3, 3.7)0.0129
CRP, mg/dL, median (IQR)0.63 (0.15, 2.2)1.3 (0.47, 4.6)0.47 (0.08, 1.71)0.0015
NLR, median (IQR)3.8 (2.7, 6.5)4.5 (3.1, 9.3)3.4 (2.3, 5.4)0.0112
Clinical symptoms, yes, %93, 84.6%41, 89.1%52, 81.2%0.2970
Table 2 Chemotherapy regimens and responses of patients with advanced gastric cancer
CharacteristicsTotalEarly WTElective WTP value
No.1104664
Chemotherapy; combination76, 70%27, 59%49, 78%0.0371
Agents
5-FU10440, 85%64, 93%0.3532
Platinum7926, 55%53, 77%0.0100
Irinotecan11, 2.1%0, 0%1.0000
Taxane148, 17%6, 8.7%0.2460
Trastuzumab199, 19%10, 14%0.6110
Ramucirumab10, 0%1, 1.5%0.4072
Response to first-line chemotherapy
CR1, 0.91%0, 0%1, 1.6%0.1721
PR23, 20.9%7, 15.2%16, 25%
SD47, 42.7%17, 37.0%30, 46.9%
PD16, 14.6%10, 21.7%6, 9.4%
NE23, 20.9%12, 26.1%11, 17.2%
RR24, 21.8%7, 15.2%17, 26.6%
DCR71,64.5%24, 52.8%47, 73.5%
Second-line chemotherapy, yes154, 63.5%24, 58.5%30, 68.2%0.3770
Table 3 Univariate and multiple logistic regression analyses of prognosis in advanced gastric cancer patients
Univariate analysis
Multivariate analysis
CategoryHR96%CIP valueHR96%CIP value
Early WT1.5020.982-2.280.06051.1320.721-1.7600.5857
CRP1.121.050-1.1850.00101.0911.001-1.1730.0335
NLR1.030.99-1.0570.05630.9900.954-1.0210.5520
Alb0.5140.354-0.7500.00050.5390.357-0.8180.0038
Chemotherapy (combination)0.6690.431-1.0650.08930.5040.408-0.8410.0094
Table 4 Using 1:1 propensity score matching including C-reactive protein level, Alb level, and the administration of combination chemotherapy, we obtained a total of 48 matched patients in the early and elective waiting time groups (this table shows the characteristics of the propensity-matched patients with advanced gastric cancer)
Propensity-matched cohort
CharacteristicsEarly WTElective WTP value
No.2424
Disease status Unresectable/recurrent23/120/40.3475
Waiting time (WT), d, median (IQR)12 (8, 13)22.5 (19.3, 33.8)< 0.0001
Male sex, n, %18, 75%18, 75%1.0000
Age, years, median (IQR)68 (61, 72)73.5 (63, 79)0.1635
BMI, median (IQR)20.7 (18.8, 22.5)20.9 (19.3, 23.2)0.5727
Diabetes mellitus, n, %3, 13%3, 13%1.0000
Hypertension, n, %10, 42%9, 39%1.0000
Dementia, n, %1, 4%1, 4%1.000
Chronic kidney disease, n, %9, 38%10 42%0.7702
Charlson comorbidity index score, median (IQR)0 (0, 0)0 (0, 0)0.9611
Low/medium/high/missing20, 2, 2, 019, 3, 1, 10.7348
PS 0-1, n, %23, 96%20, 87%0.5347
Histology type, intestinal, n, %8, 33%12, 50%0.3442
HER 2 IHC 3+< or FISH (+), n, %7, 29%8, 33%1.0000
Gastric cardia tumor site, n, %2, 8%7, 29%0.1365
Target lesion, n, %23, 96%19, 86%0.3364
No. of metastatic lesions ≤ 19, 38%10, 42%0.8541
CEA, median (IQR)6.7 (2.2, 91)8.8 (4.9, 75.5)0.7175
CA19-9, median (IQR)86 (3, 851)27 (7, 6583)0.6282
Hb, g/dL, median (IQR)11.3 (9.7, 12.9)11 (7.7, 12.3)0.5226
Alb, g/dL, median (IQR)3.3 (2.9, 3.6)3.2 (3, 3.7)0.8848
CRP, mg/dL, median (IQR)0.59 (0.26, 1.97)0.48 (0.13, 1.94)0.5707
NLR, median (IQR)3.9 (3.0, 6.7)3.1 (2.4, 5.0)0.1576
Monotherapy; combination7; 177; 171.0000