Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy

Takashi Sasaki1, Hiroyuki Isayama1, Yousuke Nakai1, Osamu Togawa1, Hirofumi Kogure1, Yukiko Ito2, Keisuke Yamamoto1, Suguru Mizuno1, Hiroshi Yagioka1, Yoko Yashima3, Kazumichi Kawakubo1, Toshihiko Arizumi1, Saburo Matsubara4, Naoki Sasahira1, Kenji Hirano1, Takeshi Tsujino2, Nobuo Toda5, Minoru Tada1, Masao Omata1, Kazuhiko Koike1
1Department of Gastroenterology, Graduate school of Medicine, the University of Tokyo, Tokyo, Japan
2Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan
3Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan
4Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan
5Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan

Tóm tắt

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. 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. 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). 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.

Từ khóa


Tài liệu tham khảo

Eckel F, Schmid RM (2007) Chemotherapy in advanced biliary tract carcinoma: a pooled analysis of clinical trials. Br J Cancer 96:896–902 Hezel AF, Zhu AX (2008) Systemic therapy for biliary tract cancers. Oncologist 13:415–423 Valle JW, Wasan HS, Palmer DD, Cunningham D, Anthoney DA, Maraveyas A, Hughes SK, Roughton M, Bridgewater JA (2009) Gemcitabine with or without cisplaltin in patients with advanced or metastatic biliary tract cancer (ABC): results of a multicenter, randomized phase III trial (the UK ABC-02 trial). Proc Am Soc Clin Oncol 27:15s (Abstract No: 4503) Ueno H, Okusaka T, Ikeda M, Takezako Y, Morizane C (2004) Phase II study of S-1 in patients with advanced biliary tract cancer. Br J Cancer 91:1769–1774 Furuse J, Okusaka T, Boku N, Ohkawa S, Sawaki A, Masumoto T, Funakoshi A (2008) S-1 monotherapy as first-line treatment in patients with advanced biliary tract cancer: a multicenter phase II study. Cancer Chemother Pharmacol 62:849–855 Sasaki T, Isayama H, Yashima Y, Yagioka H, Kogure H, Arizumi T, Togawa O, Matsubara S, Ito Y, Nakai Y, Sasahira N, Hirano K, Tsujino T, Tada M, Kawabe T, Omata M (2009) S-1 monotherapy in patients with advanced biliary tract cancer. Oncology 77:71–74 Sasaki T, Isayama H, Nakai Y, Ito Y, Kogure H, Togawa O, Toda N, Yasuda I, Hasebe O, Maetani I, Sasahira N, Hirano K, Tsujino T, Tada M, Omata M (2010) Multicenter, phase II study of gemcitabine and S-1 combination chemotherapy in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol 65:1101–1107 Saisho T, Okusaka T, Ueno H, Morizane C, Okada S (2005) Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy. Hepatogastroenterology 52:1654–1658 Furuse J, Okusaka T, Ohkawa S, Nagase M, Funakoshi A, Boku N, Yamao K, Yamaguchi T, Sato T (2009) A phase II study of uracil-tegafur plus doxorubicin and prognostic factors in patients with unresectable biliary tract cancer. Cancer Chemother Pharmacol 65:113–120 Yonemoto N, Furuse J, Okusaka T, Yamao K, Funakoshi A, Ohkawa S, Boku N, Tanaka K, Nagase M, Saisho H, Sato T (2007) A multi-center retrospective analysis of survival benefits of chemotherapy for unresectable biliary tract cancer. Jpn J Clin Oncol 37:843–851 Furuse J, Okusaka T, Miyazaki M, Tainai H, Nimura Y (2009) A randomized study of gemcitabine/cisplatin versus single-agent gemcitabine in patients with biliary tract cancer. Proc Am Soc Clin Oncol 27:15s (Abstract No: 4579) Park I, Lee JL, Ryu MH, Kim TW, Sook Lee S, Hyun Park D, Soo Lee S, Wan Seo D, Koo Lee S, Kim MH (2009) Prognostic factors and predictive model in patients with advanced biliary tract adenocarcinoma receiving first-line palliative chemotherapy. Cancer 115:4148–4155 Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216 Nakai Y, Isayama H, Sasaki T, Sasahira N, Ito Y, Kogure H, Togawa O, Matsubara S, Arizumi T, Yagioka H, Yashima Y, Kawakubo K, Mizuno S, Yamamoto K, Hirano K, Tsujino T, Ijichi H, Toda N, Tada M, Kawabe T, Omata M (2009) A pilot study for combination chemotherapy using gemcitabine and S-1 for advanced pancreatic cancer. Oncology 77:300–303 Machida N, Yoshino T, Boku N, Hironaka S, Onozawa Y, Fukutomi A, Yamazaki K, Yasui H, Taku K, Asaka M (2008) Impact of baseline sum of longest diameter in target lesions by RECIST on survival of patients with metastatic colorectal cancer. Jpn J Clin Oncol 38:689–694 Kim JH, Yoon HK, Sung KB, Ko GY, Gwon DI, Shin JH, Song HY (2008) Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma: clinical efficacy and factors influencing outcomes. Cancer 113:1614–1622 Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247