Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy.
OBJECTIVE
Prognostic factors for patients with advanced biliary tract cancer receiving chemotherapy are presently not well established. Gallbladder cancer and intra-hepatic cholangiocarcinoma are previously reported prognostic factors of poor prognosis; however, tumor volume has not been analyzed in these previous reports.


METHODS
We analyzed 56 consecutive patients with advanced biliary tract cancer who had received gemcitabine and S-1 combination chemotherapy as first-line palliative chemotherapy. Prognostic factors, including the baseline sum longest diameter (BSLD) representing tumor volume in Response Evaluation Criteria in Solid Tumor, were evaluated.


RESULTS
By multivariate analysis, age ≥70 (HR 3.01, 95% CI 1.25-7.31, P = 0.014) and larger BSLD (HR 1.09, 95% CI 1.01-1.18, P = 0.021) were statistically significant independent predictors of poor prognosis. Primary biliary site was not identified as a prognostic factor (P = 0.728). Median survival times of patients with BSLDs ≤ 9.0 cm and BSLDs > 9.0 cm were 18.7 and 8.8 months, respectively (P = 0.024).


CONCLUSIONS
Age and BSLD were identified as strong prognostic factors for patients with advanced biliary tract cancer receiving chemotherapy. Tumor volume might be more important than primary biliary site for the prognosis of advanced biliary tract cancer.
Sasaki
Takashi
T
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Isayama
Hiroyuki
H
Nakai
Yousuke
Y
Togawa
Osamu
O
Kogure
Hirofumi
H
Ito
Yukiko
Y
Yamamoto
Keisuke
K
Mizuno
Suguru
S
Yagioka
Hiroshi
H
Yashima
Yoko
Y
Kawakubo
Kazumichi
K
Arizumi
Toshihiko
T
Matsubara
Saburo
S
Sasahira
Naoki
N
Hirano
Kenji
K
Tsujino
Takeshi
T
Toda
Nobuo
N
Tada
Minoru
M
Omata
Masao
M
Koike
Kazuhiko
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010094:Oxonic Acid / Q000008:administration & dosage; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D047368:Tumor Burden / Q000187:drug effects*; D055815:Young Adult; D000093542:Gemcitabine
D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine