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Prognostic value of preoperative immunosuppressive acidic protein in patients with gastric carcinoma: Findings from three independent clinical trials
Author(s) -
Sakamoto Junichi,
Teramukai Satoshi,
Koike Akihiko,
Saji Shigetoyo,
Ohashi Yasuo,
Nakazato Hiroaki
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960601)77:11<2206::aid-cncr4>3.0.co;2-n
Subject(s) - medicine , hazard ratio , proportional hazards model , gastroenterology , cancer , oncology , clinical trial , clinical significance , carcinoma , survival analysis , confidence interval
BACKGROUND Immunosuppressive acidic protein (IAP) has been reported to have close correlation with the impairment of host immune response. To evaluate the significance of IAP in clinical studies, the prognostic value of preoperative IAP was investigated in clinical trials of patients with gastric carcinoma after curative resection. METHODS An appropriate IAP threshold value of 580 μg/mL was determined using Cox's proportional hazards model. Five‐year survival rates were estimated for high and low IAP groups in three different clinical studies. Meta‐analysis was performed based on individual patient data, and summarized hazard ratios were estimated using a stratified proportional hazards model. RESULTS Meta‐analysis of the three clinical trials demonstrated that patients with preoperative IAP levels above the threshold had significantly poorer cancer related survival ( P = 0.0039) and absolute survival ( P = 0.0023), even after adjustment for the major prognostic factors. CONCLUSIONS Gastric carcinoma patients with an IAP value above the threshold level of 580 μg/mL have a higher risk of cancer death and absolute death than patients with an IAP value below the threshold value.