Prognostic and Predictive Value of NAR Score in Gastric Cancer

J Gastrointest Cancer. 2021 Sep;52(3):1054-1060. doi: 10.1007/s12029-020-00537-2. Epub 2020 Oct 16.

Abstract

Introduction: Neoadjuvant treatment is a widely accepted approach for locally advanced rectum cancer. Efforts to explore a surrogate endpoint for clinical trials revealed a new prognostic scoring system which is named as neoadjuvant rectal score (NAR) in patients who received neoadjuvant treatment for rectal cancer.

Material and methods: 88 patients who met inclusion criteria were included in the study. The optimal cutoff value of the NAR score was 17.6 with 71% sensitivity and 63% specificity. Patients with NAR score > 17.6 (n: 48, 54%) were defined as the high-risk group and those with NAR score ≤ 17.6 (n: 40, 56%) as the low-risk group.

Result: Survival analysis according to the NAR score group (low-risk vs high-risk) revealed that there was a statistically significant difference between groups regarding OS and DFS. The median OS for high-risk patients was 27.3 months (95% CI, 15.0-39.6); it was 76.6 months (47.3-106.0) for low-risk patients (p < 0.0001). The median DFS was 15.1 months (11.8-18.4) for high-risk patients; it was 44.3 months (95% CI, 4.1-84.6) in the low-risk group (p = 0.002).

Discussion: As a result, we interpreted our findings as supporting data about the utility of NAR score not only as a surrogate endpoint for the clinical trial of rectal cancer but also as a prognostic marker in patients with gastric cancer who received neoadjuvant treatment.

Keywords: Gastric cancer; NAR score; Neoadjuvant; Predictive; Prognostic.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Predictive Value of Tests
  • Prognosis*
  • ROC Curve
  • Rectal Neoplasms
  • Risk Assessment / methods*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / surgery
  • Turkey / epidemiology