Asian Pacifc Journal of Cancer Prevention, Vol 13, 2012 3869 DOI:http://dx.doi.org/10.7314/APJCP.2012.13.8.3869 Prognostic Factors for First-Line Chemotherapy Treated Metastatic Gastric Cancer Asian Pacifc J Cancer Prev, 13, 3869-3872 Introduction Despite the reduced incidence, gastric cancer is the second most common among cancer-related deaths in the word. In two-third of patients with gastric cancer are diagnosed with metastatic disease (Kamangar et al., 2006; Jemal et al., 2011). Without effective treatment, the median survival for metastatic disease is 3 to 5, however it may be extended 8-12 months with the platinum and taxane-containing regimens (Van Cutsem et al., 2006; Roth et al., 2007). Randomized trials have shown that systemic chemotherapy resulted in a signifcant survival benefits when compared with best supportive care (Murad et al., 1993; Pyrhonen et al., 1995; Glimelius et al., 1997). The meta-analysis by Wagner et al. suggests that the combination chemotherapy response rates over monotherapy alone in patients with advanced gastric cancer (Wagner et al., 2006). In the Tax 325 study, two regimens were compared; 75 mg/m² docetaxel and cisplatin on day 1 and 750 mg/m² 5-Fluorouracil continuous infusion per day on days 1-5, every 3 weeks (DCF) versus cisplatin 100 mg/m² on day 1 and 1000 mg/ m² 5-Fluorouracil continuous infusion per day on days 1 Department of Medical Oncology, 2 Department of Internal Medicine, 3 Department of Biochemistry, Dicle University, Diyarbakir, Turkey *For correspondence: dr.ainal@gmail.com, dr.ali33@mynet.com Abstract Background: The majority of patients with gastric cancer in developing countries present with advanced disease. Systemic chemotherapy therefore has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyze prognostic factors for survival in advanced gastric cancer patients undergoing frst-line palliative chemotherapy. Methods: We retrospectively reviewed 107 locally advanced or metastatic gastric cancer patients who were treated with docetaxel and cisplatin plus fuorouracil (DCF) as frst-line treatment between June 2007 and August 2011. Twenty-eight potential prognostic variables were chosen for univariate and multivariate analyses. Results: Among the 28 variables of univariate analysis, nine variables were identifed to have prognostic signifcance: performance status, histology, location of primary tumor, lung metastasis, peritoneum metastasis, ascites, hemoglobin, albumin, weight loss and bone metastasis. Multivariate analysis by Cox proportional hazard model, including nine prognostic signifcance factors evident in univariate analysis, revealed weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level to be independent variables. Conclusion: Performance status, weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level were identifed as important prognostic factors in advanced gastric cancer patients. These fndings may facilitate pretreatment prediction of survival and can be used for selecting patients for treatment. Keywords: Gastric cancer - frst-line chemotherapy - prognostic factors RESEARCH ARTICLE Prognostic Factors in First-Line Chemotherapy Treated Metastatic Gastric Cancer Patients: A Retrospective Study Ali Inal 1 *, M Ali Kaplan 1 , Mehmet Kuçukoner 1 , Zuhat Urakcı 1 , Mehmet Guven 2 , Necip Nas 2 , Muharrem Yunce 3 , Abdurrahman Işıkdogan 1 1–5, every 4 weeks (CF). The DCF arm response rates (37 vs 25%) and overall survival (OS) higher than CF arm, while the toxicities of grade 3 to 4 was higher in the DCF arm (Van Cutsem et al., 2006). Very different prognostic factors in several studies have been identifed for survival in patients with advanced gastric cancer (Tsujitani et al., 2001; Chau et al., 2004; Yoshida et al., 2004; Kim et al., 2008; Roshanaei et al., 2011; Maroufzadeh., 2012). Systemic chemotherapy for patients with gastric cancer has limited impact on OS due to not only a low response rates, but also severe side effects. Determining the prognostic factors of survival for metastatic gastric cancer patients with first-line chemotherapy treated patients can help physicians in the decision-making process for individual patients. We performed a retrospective analysis of prognostic factors in the metastatic gastric cancer patients treated with frst-line DCF chemotherapy. Materials and Methods Patient Population We retrospectively reviewed 107 locally advanced or