The Implication of Chuang's Prognostic Scale in Metastatic Gastric Cancer

Background: Patients with metastatic gastric cancer (mGC) endure a significant symptom burden following subsequent lines of therapy. Accurate survival estimation is crucial for healthcare professionals and patients to make informed decisions regarding therapy options. This study evaluates Chuang's Prognostic Scale (CPS) for predicting survival in mGC patients after receiving at least two lines of palliative systemic therapy (PST).Method: This prospective study involved 202 patients with mGC. The CPS includes eight categories: cognitive impairment, performance status, weight loss, tiredness, edema, and ascites, with a scoring range from 0 to 8.5. A higher score indicates a poorer prognosis.Results: After a median follow-up period of 3.35 months, the median CPS value was 4.2. 99 patients had a CPS < 4.2, with a median overall survival (mOS) of 5.86 months, while 103 patients with a CPS ≥ 4.2 had an mOS of 3.96 months (P < 0.001). According to the receiver-operating curve, the cut-off value for CPS was ≤ 4.7, with a disease prevalence of 76.7% and an area under the curve of 0.949 (P < 0.0001). The sensitivity was 82.6%, specificity was 97.87%, positive predictive value was 99.2%, and negative predictive value was 63%. Cox regression analysis revealed that CPS was statistically significantly associated with mOS (P < 0.001). Furthermore, CPS was statistically significantly correlated with metastases to the liver, lung, lymph nodes, and bone (P values were 0.03, 0.02, <0.001, and <0.001, respectively).Conclusion: CPS is a valuable and accessible tool that can assist in selecting appropriate therapy for patients with mGC after two lines of PST