Prognostic Factors and Scoring Model for Survival in Metastatic Biliary Tract Cancer.
- Author:
Hyung Soon PARK
1
;
Ji Soo PARK
;
You Jin CHUN
;
Yun Ho ROH
;
Jieun MOON
;
Hong Jae CHON
;
Hye Jin CHOI
;
Joon Seong PARK
;
Dong Ki LEE
;
Se Joon LEE
;
Dong Sup YOON
;
Hei Cheul JEUNG
Author Information
- Publication Type:Original Article
- Keywords: Biliary tract neoplasms; Prognosis; Scoring model; Survival; Validation; Drug therapy
- MeSH: Biliary Tract Neoplasms*; Biliary Tract*; Carcinoembryonic Antigen; Dataset; Drug Therapy; Humans; Hypoalbuminemia; Multivariate Analysis; Prognosis; Proportional Hazards Models; Reference Values; Social Identification
- From:Cancer Research and Treatment 2017;49(4):1127-1139
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. MATERIALS AND METHODS: From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox’s proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. RESULTS: The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia (< 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell’s C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. CONCLUSION: These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.
