Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;5(2):e000623.
doi: 10.1136/esmoopen-2019-000623.

Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms (VAGAS score): characterisation of alarm symptoms in advanced gastro-oesophageal cancer and its correlation with outcome

Hannah Christina Puhr  1   2 , Eleonore Pablik  3 , Anna Sophie Berghoff  1 , Gerd Jomrich  2   4 , Sebastian Friedrich Schoppmann  2   4 , Matthias Preusser  1   2 , Aysegül Ilhan-Mutlu  5   2
Affiliations

Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms (VAGAS score): characterisation of alarm symptoms in advanced gastro-oesophageal cancer and its correlation with outcome

Hannah Christina Puhr et al. ESMO Open. 2020 Mar.

Abstract

Introduction: The prognostic value of symptoms at disease presentation of advanced gastro-oesophageal cancer is unknown. Thus, the aim of this study was to characterise these symptoms and correlate them with the outcome, so new prognostic markers can be defined.

Methods: We analysed clinical data including symptoms, therapies and survival of patients with stage IV gastro-oesophageal cancer treated between 2002 and 2018 at the Vienna General Hospital, Austria. Initial symptoms as well as stenosis in endoscopy and HER2 positivity were evaluated in a cross-validation model to ascertain the impact of each variable on patient survival.

Results: In total, 258 patients were evaluated. Five factors (stenosis in endoscopy, weight loss, HER2 positivity, dyspepsia, ulcer or active bleeding) have proven to be statistically relevant prognostic factors and were given a count of +1 and -1, if applicable. The resulting score ranges between -3 and +2. The survival probability for 180 days with a score of -3/-2, -1, 0, +1 and +2 is 90%, 80%, 73%, 72% and 42%, whereas for 2 years, it is 30%, 30%, 8%, 7% and 3%, respectively. The median overall survival of a score of -3/-2, -1, 0, +1 and +2 was 579 (95% CI 274 to not measurable), 481 (95% CI 358 to 637), 297 (95% CI 240 to 346), 284 (95% CI 205 to 371), 146 (95% CI 120 to 229) days, respectively.

Conclusion: The data from this retrospective study indicate that the Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms score provides independent prognostic information that may support clinical decision making at diagnosis of advanced gastro-oesophageal cancer. Our findings should be evaluated in prospective studies.

Keywords: esophagus; gastric; gastroesophageal; prognosis; score.

PubMed Disclaimer

Conflict of interest statement

Competing interests: HCP has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche. ASB has research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo and AbbVie. MP has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, MedMedia, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo and Merck Sharp & Dome. AI-M participated in advisory boards from MSD and Servier, received lecture honoraria from Eli Lilly and Servier and is the local principal investigator for clinical trials sponsored by BMS and Astellas.

Figures

Figure 1
Figure 1
Kaplan-Meier survival analyses regarding chemotherapy, HER2 positivity, dysphagia, dyspepsia, stenosis in endoscopy, active bleeding or ulcers, weight loss and frailty.
Figure 2
Figure 2
Overall survival based on the VAGAS score in our cohort of 258 patients with stage IV upper gastrointestinal cancer. VAGAS, Viennese risk prediction score for advanced Gastroesophageal carcinoma based on Alarm Symptoms.
Figure 3
Figure 3
Survival probabilities in regard of the VAGAS score for 2 years, 1 year and 180 days. VAGAS, Viennese risk prediction score for advanced Gastroesophageal carcinoma based on Alarm Symptoms.
See this image and copyright information in PMC

References

    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359–86. 10.1002/ijc.29210 - DOI - PubMed
    1. Smyth EC, Verheij M, Allum W, et al. Gastric cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016;27:v38–49. 10.1093/annonc/mdw350 - DOI - PubMed
    1. Kapoor N, Bassi A, Sturgess R, et al. Predictive value of alarm features in a rapid access upper gastrointestinal cancer service. Gut 2005;54:40–5. 10.1136/gut.2004.039438 - DOI - PMC - PubMed
    1. Lee S-W, Chang C-S, Yeh H-J, et al. The diagnostic value of alarm features for identifying types and stages of upper gastrointestinal malignancies. Gastroenterology Res 2017;10:120–5. 10.14740/gr826w - DOI - PMC - PubMed
    1. Axon A. Symptoms and diagnosis of gastric cancer at early curable stage. Best Pract Res Clin Gastroenterol 2006;20:697–708. 10.1016/j.bpg.2006.03.015 - DOI - PubMed

Publication types