Tadayuki Kou1, Masashi Kanai2, Michio Yamamoto3, Peng Xue2, Yukiko Mori4, Yasushi Kudo5, Akira Kurita5, Norimitsu Uza6, Yuzo Kodama6, Masanori Asada5, Michiya Kawaguchi7, Toshihiko Masui7, Masaki Mizumoto7, Shujiro Yazumi5, Shigemi Matsumoto2, Kyoichi Takaori7, Satoshi Morita3, Manabu Muto8, Shinji Uemoto7, Tsutomu Chiba6. 1. Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimach, Kita-ku, Osaka, 530-8480, Japan. tadayuki.kou@gmail.com. 2. Department of Clinical Oncology and Pharmacogenomics, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 3. Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 4. Department of Translational Clinical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 5. Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimach, Kita-ku, Osaka, 530-8480, Japan. 6. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 7. Division of Hepatobiliary Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 8. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Abstract
BACKGROUND: We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors. METHODS: The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves. RESULTS: Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors-performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil-lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows-PI = 2 (if PS 2-3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups-favorable (PI 0-1, n = 73), intermediate (PI 2-3, n = 145), and poor (PI 4-8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658. CONCLUSIONS: This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.
BACKGROUND: We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors. METHODS: The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves. RESULTS: Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors-performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil-lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows-PI = 2 (if PS 2-3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups-favorable (PI 0-1, n = 73), intermediate (PI 2-3, n = 145), and poor (PI 4-8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658. CONCLUSIONS: This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.
Entities:
Keywords:
Palliative chemotherapy; Pancreatic cancer; Prognostic model
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