SCI Journal Article Index
Prognostic Factors and Scoring Model for Survival in Metastatic Biliary Tract Cancer
Hyung Soon Park, 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
Background: 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 χ² scores for the factors identified by multivariate analysis.
Results: The performance status (ECOG 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.
Conclusions: These proposed prognostic criteria for metastatic BTC can facilitate accurate patient risk stratification and treatment-related decision-making.
- PMID: 28161931