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Prognostic factors for survival in patients with advanced oesophageal cancer treated with cisplatin-based combination chemotherapy.

Polee MB, Hop WC, Kok TC, Eskens FA, van der Burg ME, Splinter TA, Siersema PD, Tilanus HW, Stoter G, van der Gaast A - Br. J. Cancer (2003)

Bottom Line: The 1, 2 and 5-year survival rates were 33, 12 and 4%, respectively.Although weight loss, liver metastases and alkaline phosphatase were significant prognostic factors in univariate analyses, these factors lost their significance in multivariate analyses.The median survival for patients without any risk factors was 12 months, compared to only 4 months in patients with WHO 2 plus elevated LDH and extensive disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. m.polee@planet.nl

ABSTRACT
The objective of this study was to identify prognostic factors for survival in patients with advanced oesophageal cancer, who are treated with cisplatin-based combination chemotherapy. We analysed the baseline characteristics of 350 patients who were treated in six consecutive prospective trials with one of the following regimens: cisplatin/etoposide, cisplatin/etoposide/5-fluorouracil, cisplatin/paclitaxel (weekly) and cisplatin/paclitaxel (biweekly). Predictive factors in univariate analyses were further evaluated using multivariate analysis (Cox regression). The median survival of all patients was 9 months. The 1, 2 and 5-year survival rates were 33, 12 and 4%, respectively. The main prognostic factors were found to be WHO performance status (0 or 1 vs 2), lactate dehydrogenase (normal vs elevated), extent of disease (limited disease defined as locoregional irresectable disease or lymph node metastases confined to either the supraclavicular or celiac region vs extensively disseminated disease) in addition to the type of treatment (weekly or biweekly cisplatin/paclitaxel regimen vs 4-weekly cisplatin/etoposide with or without 5-fluorouracil). Although weight loss, liver metastases and alkaline phosphatase were significant prognostic factors in univariate analyses, these factors lost their significance in multivariate analyses. The median survival for patients without any risk factors was 12 months, compared to only 4 months in patients with WHO 2 plus elevated LDH and extensive disease. The performance status, extent of disease, LDH and the addition of paclitaxel to cisplatin are independent prognostic factors in patients with advanced oesophageal cancer, who are treated with cisplatin-based combination chemotherapy.

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Related in: MedlinePlus

Kaplan–Meier survival curves for patients with 0–3 risk factors (A=no risk factor, B=one risk factor, C=two risk factors, D=three risk factors). The risk factors are WHO 2, extensive disseminated disease and elevated LDH.
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fig1: Kaplan–Meier survival curves for patients with 0–3 risk factors (A=no risk factor, B=one risk factor, C=two risk factors, D=three risk factors). The risk factors are WHO 2, extensive disseminated disease and elevated LDH.

Mentions: We combined the patient characteristics such as performance status, extent of disease and LDH, to constitute four groups. A WHO performance score of 2, extensive disseminated disease and an elevated LDH were risk factors for poor survival, and the survival of patients with either 0, 1, 2 or 3 risk factors present was estimated. As shown in Figure 1Figure 1


Prognostic factors for survival in patients with advanced oesophageal cancer treated with cisplatin-based combination chemotherapy.

Polee MB, Hop WC, Kok TC, Eskens FA, van der Burg ME, Splinter TA, Siersema PD, Tilanus HW, Stoter G, van der Gaast A - Br. J. Cancer (2003)

Kaplan–Meier survival curves for patients with 0–3 risk factors (A=no risk factor, B=one risk factor, C=two risk factors, D=three risk factors). The risk factors are WHO 2, extensive disseminated disease and elevated LDH.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376851&req=5

fig1: Kaplan–Meier survival curves for patients with 0–3 risk factors (A=no risk factor, B=one risk factor, C=two risk factors, D=three risk factors). The risk factors are WHO 2, extensive disseminated disease and elevated LDH.
Mentions: We combined the patient characteristics such as performance status, extent of disease and LDH, to constitute four groups. A WHO performance score of 2, extensive disseminated disease and an elevated LDH were risk factors for poor survival, and the survival of patients with either 0, 1, 2 or 3 risk factors present was estimated. As shown in Figure 1Figure 1

Bottom Line: The 1, 2 and 5-year survival rates were 33, 12 and 4%, respectively.Although weight loss, liver metastases and alkaline phosphatase were significant prognostic factors in univariate analyses, these factors lost their significance in multivariate analyses.The median survival for patients without any risk factors was 12 months, compared to only 4 months in patients with WHO 2 plus elevated LDH and extensive disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. m.polee@planet.nl

ABSTRACT
The objective of this study was to identify prognostic factors for survival in patients with advanced oesophageal cancer, who are treated with cisplatin-based combination chemotherapy. We analysed the baseline characteristics of 350 patients who were treated in six consecutive prospective trials with one of the following regimens: cisplatin/etoposide, cisplatin/etoposide/5-fluorouracil, cisplatin/paclitaxel (weekly) and cisplatin/paclitaxel (biweekly). Predictive factors in univariate analyses were further evaluated using multivariate analysis (Cox regression). The median survival of all patients was 9 months. The 1, 2 and 5-year survival rates were 33, 12 and 4%, respectively. The main prognostic factors were found to be WHO performance status (0 or 1 vs 2), lactate dehydrogenase (normal vs elevated), extent of disease (limited disease defined as locoregional irresectable disease or lymph node metastases confined to either the supraclavicular or celiac region vs extensively disseminated disease) in addition to the type of treatment (weekly or biweekly cisplatin/paclitaxel regimen vs 4-weekly cisplatin/etoposide with or without 5-fluorouracil). Although weight loss, liver metastases and alkaline phosphatase were significant prognostic factors in univariate analyses, these factors lost their significance in multivariate analyses. The median survival for patients without any risk factors was 12 months, compared to only 4 months in patients with WHO 2 plus elevated LDH and extensive disease. The performance status, extent of disease, LDH and the addition of paclitaxel to cisplatin are independent prognostic factors in patients with advanced oesophageal cancer, who are treated with cisplatin-based combination chemotherapy.

Show MeSH
Related in: MedlinePlus