A Risk Score System to Preoperatively Predict TNM Stages in Gastric Cancer

Abstract

To improve the estimation of tumor status and facilitate the stage-dependent treatment planning, we developed a reliable and easy-to-use risk score for prediction of tumor-node-metastasis stages in gastric cancer. Clinicopathological data were collected prospectively from 108 curatively resected patients with gastric cancer. The risk score was established on the basis of independent predictive factors for tumor stages, and its performance was evaluated by receiver operating characteristic (ROC) analysis. The following 4 independent factors were included in our score: serum albumin levels, tumor size, T and N categories determined by helical computed tomography. Using ROC analysis, we chose a score at 7 as the optimal cut point for differentiating the more advanced disease (stage III/IV) from the less advanced one (stage I/II). With the defined cut point, our score allowed predicting stage III/IV with sensitivity of 79.6%, specificity of 85.2%, and accuracy of 82.4%. The discriminative ability of this score was good (the area under the ROC curve, 0.861-0.965). The risk score may be helpful to preoperative gastric cancer staging. It probably assists surgeons in deciding the extent of surgery and in choosing the appropriate perioperative adjuvant therapies.