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Br J Cancer. 2014 Apr 29;110(9):2165-9. doi: 10.1038/bjc.2014.190. Epub 2014 Apr 8.

Multivariate prognostic factors analysis for second-line chemotherapy in advanced biliary tract cancer.

Author information

1
Department of Oncology, Unit of Medical Oncology, Azienda USL2 Lucca Via dell'Ospedale 1, 55100 Lucca, Italy.
2
Department of Medical Oncology, San Raffaele Scientific Institute, 20133 Milano, Italy.
3
Department of Oncology, University and General Hospital, 33100 Udine, Italy.
4
Unit of Medical Oncology, Sant'Orsola Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
5
Medical Oncology, University Campus Bio-Medico, 00128 Roma, Italy.
6
Unit of Medical Oncology, National Cancer Institute Giovanni Paolo II, 70124 Bari, Italy.
7
Unit of Medical Oncology 1, Istituto Oncologico Veneto-IRCCS, 35128 Padova, Italy.
8
Unit of Medical Oncology, Institute for Cancer Research and Treatment IRCCS Candiolo, University of Torino, 10060 Torino, Italy.
9
Medical Oncology A, Regina Elena National Cancer Institute, 00144 Roma, Italy.
10
Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, 56126 Pisa, Italy.

Abstract

BACKGROUND:

The role of second-line chemotherapy (CT) is not established in advanced biliary tract cancer (aBTC). We investigated the outcome of aBTC patients treated with second-line CT and devised a prognostic model.

METHODS:

Baseline clinical and laboratory data of 300 consecutive aBTC patients were collected and association with overall survival (OS) was investigated by multivariable Cox models.

RESULTS:

The following parameters resulted independently associated with longer OS: Eastern Cooperative Oncology Group performance status of 0 (P<0.001; hazard ratio (HR), 0.348; 95% confidence interval (CI) 0.215-0.562), CA19.9 lower than median (P=0.013; HR, 0.574; 95% CI 0.370-0.891), progression-free survival after first-line CT ≥ 6 months (P=0.027; HR, 0.633; 95% CI 0.422-0.949) and previous surgery on primary tumour (P=0.027; HR, 0.609; 95% CI 0.392-0.945). We grouped the 249 patients with complete data available into three categories according to the number of fulfilled risk factors: median OS times for good-risk (zero to one factors), intermediate-risk (two factors) and poor-risk (three to four factors) groups were 13.1, 6.6 and 3.7 months, respectively (P<0.001).

CONCLUSIONS:

Easily available clinical and laboratory factors predict prognosis of aBTC patients undergoing second-line CT. This model allows individual patient-risk stratification and may help in treatment decision and trial design.

PMID:
24714745
PMCID:
PMC4007244
DOI:
10.1038/bjc.2014.190
[Indexed for MEDLINE]
Free PMC Article
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