Jun Ho Ji1, Haa-Na Song2, Rock Bum Kim3, Sung Yong Oh4, Ho Yeong Lim5, Joon Oh Park5, Se Hoon Park5, Moon Jin Kim5, Soon Il Lee6, Sung Hyeok Ryou6, In Gyu Hwang7, Joung-Soon Jang7, Hong Jun Kim8, Jun Young Choi9, Jung-Hun Kang10. 1. Division of Hematology and Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon. 2. Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju. 3. Dong-A University Department of Preventive Medicine, School of Medicine, Busan. 4. Department of Internal Medicine, Dong-A University College of Medicine, Busan. 5. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul. 6. Department of Internal Medicine, Dankook University College of Medicine, Cheonan. 7. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul. 8. Department of Internal Medicine, Institute of Health Science, School of Medicine, Gyeongsang National University, Jinju. 9. Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Jinju, South Korea. 10. Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju newatp@naver.com.
Abstract
BACKGROUND: Although chemotherapy is widely recommended for patients with metastatic biliary tract cancer, the natural course of these patients, especially those with good performance status who are indicated for chemotherapy, is not known. METHODS: We retrospectively reviewed patients with metastatic or locally advanced biliary cancer who were diagnosed at six cancer centers. Patients were eligible if they had good performance (ECOG 0-2) and no history of any treatment for cancer. The primary objective was to evaluate the survival time of patients with advanced biliary cancer with good performance who were untreated. RESULTS: Of the 1677 patients, 204 met the inclusion criteria. The median age and overall survival were 72.0 years and 7.1 months. Overall survival (months) by location was 4.7 for intrahepatic, 9.7 for extrahepatic, 4.4 for gallbladder and 11.2 for ampulla of vater cancer. In subgroup analysis, overall survival of locally advanced biliary cancer was 13.8 months and that of patients with normal carcinoembryonic antigen/carbohydrate antigen 19-9 was 10.6 months. In multivariate analysis, variables that were associated with poor prognosis were metastatic biliary cancer [hazard ratio 2.19 (P = 0.001)], high baseline carcinoembryonic antigen level (defined as >4.0 ng/ml) [hazard ratio 1.51 (P = 0.024)] and high baseline carbohydrate antigen 19-9 level (defined as >100 U/ml) [hazard ratio 1.93 (P = 0.001)]. CONCLUSIONS: Advanced biliary tract cancer with good performance status showed modest survival without any treatment. Furthermore, subgroup analysis showed that patients with normal carbohydrate antigen 19-9 or carcinoembryonic antigen level or locally advanced status had favorable survival. Further studies comparing the outcome of chemotherapy with that of best supportive care in patients with unresectable biliary tract cancer are warranted.
BACKGROUND: Although chemotherapy is widely recommended for patients with metastatic biliary tract cancer, the natural course of these patients, especially those with good performance status who are indicated for chemotherapy, is not known. METHODS: We retrospectively reviewed patients with metastatic or locally advanced biliary cancer who were diagnosed at six cancer centers. Patients were eligible if they had good performance (ECOG 0-2) and no history of any treatment for cancer. The primary objective was to evaluate the survival time of patients with advanced biliary cancer with good performance who were untreated. RESULTS: Of the 1677 patients, 204 met the inclusion criteria. The median age and overall survival were 72.0 years and 7.1 months. Overall survival (months) by location was 4.7 for intrahepatic, 9.7 for extrahepatic, 4.4 for gallbladder and 11.2 for ampulla of vater cancer. In subgroup analysis, overall survival of locally advanced biliary cancer was 13.8 months and that of patients with normal carcinoembryonic antigen/carbohydrate antigen 19-9 was 10.6 months. In multivariate analysis, variables that were associated with poor prognosis were metastatic biliary cancer [hazard ratio 2.19 (P = 0.001)], high baseline carcinoembryonic antigen level (defined as >4.0 ng/ml) [hazard ratio 1.51 (P = 0.024)] and high baseline carbohydrate antigen 19-9 level (defined as >100 U/ml) [hazard ratio 1.93 (P = 0.001)]. CONCLUSIONS:Advanced biliary tract cancer with good performance status showed modest survival without any treatment. Furthermore, subgroup analysis showed that patients with normal carbohydrate antigen 19-9 or carcinoembryonic antigen level or locally advanced status had favorable survival. Further studies comparing the outcome of chemotherapy with that of best supportive care in patients with unresectable biliary tract cancer are warranted.
Authors: Jun Ho Ji; Young Saing Kim; Inkeun Park; Soon Il Lee; Rock Bum Kim; Joon Oh Park; Sung Yong Oh; In Gyu Hwang; Joung-Soon Jang; Haa-Na Song; Jung-Hun Kang Journal: Cancer Res Treat Date: 2017-08-23 Impact factor: 4.679
Authors: Benjamin Goeppert; Marcus Renner; Stephan Singer; Thomas Albrecht; Qiangnu Zhang; Arianeb Mehrabi; Anita Pathil; Christoph Springfeld; Bruno Köhler; Christian Rupp; Karl Heinz Weiss; Anja A Kühl; Ruza Arsenic; Ulrich Frank Pape; Arndt Vogel; Peter Schirmacher; Stephanie Roessler; Nalân Utku Journal: Sci Rep Date: 2019-03-13 Impact factor: 4.379