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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 
 Cancer Research and Treatment, Vol.49(4) : 1127-1139, 2017 
Journal Title
 Cancer Research and Treatment 
Issue Date
Aged ; Aged, 80 and over ; Biliary Tract Neoplasms/diagnosis* ; Biliary Tract Neoplasms/mortality* ; Biliary Tract Neoplasms/therapy ; Biomarkers, Tumor ; Biopsy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Korea/epidemiology ; Male ; Middle Aged ; Models, Statistical* ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Treatment Outcome
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박지수(Park, Ji Soo) ORCID logo https://orcid.org/0000-0002-0023-7740
이동기(Lee, Dong Ki) ORCID logo https://orcid.org/0000-0002-0048-9112
이세준(Lee, Se Joon) ORCID logo https://orcid.org/0000-0002-2695-2670
정희철(Jeung, Hei Cheul) ORCID logo https://orcid.org/0000-0003-0952-3679
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