Preoperative Memorial Sloan Kettering Prognostic Score and Long-Term Survival After Surgery for Early-Stage Gastric Cancer

Abstract

Background

In early-stage gastric cancer (GC), survival is frequently determined not by tumor biology but by competing non-cancer-related risks, yet robust prognostic markers for this setting are lacking. We sought to determine whether the Memorial Sloan Kettering prognostic score (MPS) provides clinically meaningful prognostic information in patients with early GC.

Methods

We retrospectively analyzed 108 consecutive patients with pathological stage I GC who underwent curative surgical resection. The prognostic impact of preoperative MPS on overall survival (OS) was examined using Cox proportional hazards modeling.

Results

Over a median follow-up of 58 months, 26 deaths occurred, only one of which was cancer-related. Patients were stratified as MPS 0 (n = 56), MPS 1 (n = 45), and MPS 2 (n = 7). Preoperative MPS correlated significantly with age, sex, performance status, and Glasgow prognostic score (GPS). Preoperative MPS, but not GPS, significantly predicted OS on univariate analysis. On multivariate analysis, MPS emerged as a powerful, independent predictor of OS (MPS 1 vs 0: hazard ratio [HR] 3.64, 95% confidence interval [CI] 1.22-10.85; MPS 2 vs 0: HR 7.18, 95% CI 1.43-36.08; P = .031).

Discussion

Preoperative MPS robustly stratified mortality risk in patients undergoing curative surgery for early-stage GC. This finding may reposition MPS as a marker of global vulnerability and highlight its potential role in guiding risk-adapted surgical decision-making in GC population.