Predictive factors of the treatment outcome in patients with advanced biliary tract cancer receiving gemcitabine plus cisplatin as first-line chemotherapy
BackgroundFew studies have clearly identified the prognostic factors in patients with advanced biliary tract cancer (BTC) receiving gemcitabine plus cisplatin (GC) which is acknowledged as standard chemotherapy regimen.ObjectivesThe aim of this study was to identify predictive factors of the overall survival (OS) in advanced BTC patients receiving GC therapy.MethodsData of 307 patients with advanced BTC who received GC therapy as the first-line chemotherapy at our institution from January 2007 to June 2017 were reviewed retrospectively. The patients were randomly assigned to the investigation or the validation dataset at the ratio of 2:1. Multivariate analysis was conducted to identify the prognostic factors, a prognostic index is proposed from the investigation dataset, and the usefulness of this index was confirmed in the validation dataset.ResultsMultivariate analysis identified poor performance status, elevated serum lactate dehydrogenase, and elevated neutrophil-to-lymphocyte ratio as independent unfavorable predictors. The patients could be classified into three groups according to these factors, and it was found that the outcomes differed significantly among the three groups (P=0.0002, good- vs. intermediate-prognosis groups; P=0.005, intermediate- vs. poor-prognosis groups). When this index was applied to the validation dataset, the OS was confirmed to differ significantly among the three groups (P=0.04, good- vs. intermediate-prognosis groups, P<0.0001, intermediate- vs. poor-prognosis groups).ConclusionsWe identified three predictors of the OS in patients with advanced BTC receiving GC therapy in this study, based on which we could classify the patients into three risk groups.
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Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South KoreaSungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
Kim, Seung Tae
Yoo, Kwai Han
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Gachon Univ, Gil Med Ctr, Coll Med, Div Hematol & Oncol,Dept Internal Med, Incheon, South KoreaSungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
Yoo, Kwai Han
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Hong, Jung Yong
Park, Young Suk
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Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South KoreaSungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
Park, Young Suk
Lim, Ho Yeong
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Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South KoreaSungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
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Chiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, ThailandChiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, Thailand
Thongprasert, S
Napapan, S
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Chiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, ThailandChiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, Thailand
Napapan, S
Charoentum, C
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Chiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, ThailandChiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, Thailand
Charoentum, C
Moonprakan, S
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Chiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, ThailandChiang Mai Univ, Fac Med, Div Med Oncol, Dept Med, Chiang Mai 50200, Thailand
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Hop St Antoine, Serv Oncol Med, 18 Rue Faubourg St Antoine, F-75012 Paris, FranceHop St Antoine, Serv Oncol Med, 18 Rue Faubourg St Antoine, F-75012 Paris, France
Blondet, Laure
Sarabi, Matthieu
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Ctr Leon Berard Lyon, Ctr Rech Canc Lyon, Dept Cancerol Med Grp Oncol & Endoscopie Dig, UMR Inserm 1052,Canc Immune Surveillance & Therap, Lyon, FranceHop St Antoine, Serv Oncol Med, 18 Rue Faubourg St Antoine, F-75012 Paris, France