Published online Oct 24, 2021. doi: 10.5306/wjco.v12.i10.935
Peer-review started: March 31, 2021
First decision: June 28, 2021
Revised: July 3, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: October 24, 2021
Processing time: 205 Days and 7.9 Hours
Palliative gastrectomy is the initial treatment option for locally advanced gastric cancer (GC) with gastric outlet obstruction whenever it is feasible. Unfortunately, in some cases, nasoenteric tube or jejunostomy becomes the therapeutic alternative to allow maintenance of nutritional enteral support.
The limited survival of these patients raises doubts about who benefits from jejunostomy.
This study aimed to create a prognostic score for 90-d mortality for stage IV GC patients who underwent jejunostomy based on the clinical variables related to survival.
We conducted a retrospective analysis of 80 stage IV patients who underwent jejunostomy for obstructive GC. To create a scoring system, patients were randomized into two groups (1:1) by computer using statistical software. The score was developed with half of the patients and further evaluated in a validation cohort with the remaining patients. The score was developed with 90-d mortality as the main outcome.
We provided a simple and feasible score system with 11 variables easily available in the clinical assessment of patients. The score demonstrated an accuracy of 75.6% in the validation cohort and was associated with the mortality rates in patients who underwent jejunostomy.
The scoring system developed with variables related to patient’s performance status and medical condition was able to distinguish patients submitted to jejunostomy with a high risk of 90 d mortality.
The results of our series may contribute to identifying stage IV GC with unresectable tumors who can obtain better results with the jejunostomy. In addition, the score may contribute to the selection of patients who were able to receive chemotherapy, and thereby improving their survival.