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Journal of Cancer Research and Clinical Oncology

, Volume 141, Issue 9, pp 1653–1660

First Online: 20 March 2015Received: 31 October 2014Accepted: 06 March 2015DOI: 10.1007-s00432-015-1953-y

Cite this article as: Xue, P., Zhu, L., Wan, Z. et al. J Cancer Res Clin Oncol 2015 141: 1653. doi:10.1007-s00432-015-1953-y

Abstract

PurposeTo establish a prognostic index model for advanced pancreatic cancer patients receiving palliative chemotherapy based on clinical variables.

MethodsThe clinical data of 118 patients with advanced pancreatic cancer who received palliative chemotherapy between January 2006 and August 2013 in our center were retrospectively analyzed. Prognostic factors for overall survival were identified using Cox proportional hazards model. A prognostic index model was established by these pretreatment factors to predict prognosis. Kaplan–Meier estimation and log-rank test were performed to compare the overall survival difference between low-risk and high-risk group of patients.

ResultsMedian overall survival time for all patients was 8.8 months 95 % confidence interval CI 7.0–10.6 months. Multivariate analysis identified ECOG score = 2 hazard ratio 2.03; 95 % CI 1.07–3.85; P = 0.030, CA19-9 levels of ≥1000 U-mL hazard ratio 2.07; 95 % CI 1.09–3.92; P = 0.026, and CRP levels of ≥5 mg-L hazard ratio 2.05; 95 % CI 1.06–3.96; P = 0.033 as independent poor prognostic factors for overall survival. For the three factors, ECOG score = 2, CA19-9 levels of ≥1000 U-mL, and CRP levels of ≥5 mg-L were allocated 1 point each. There were 84 71.2 % patients allocated to low-risk group with total score 0–1 point, and 34 28.8 % patients were categorized as high-risk group with total scores 2–3 points. The median overall survival for low-risk group and high-risk group was 9.9 months 95 % CI 6.8–13.0 and 5.3 months 95 % CI 4.1–6.5, respectively hazard ratio 0.27; 95 % CI 0.14–0.52; P < 0.001. The estimated 1-year survival rates for low-risk group and high-risk group were 40.5 and 5.9 %, respectively P < 0.05.

ConclusionsA novel prognostic index model based on three clinical parameters was established to predict the prognosis of patients with advanced pancreatic cancer receiving palliative chemotherapy.

KeywordsAdvanced pancreatic cancer Prognostic index model Palliative chemotherapy AbbreviationsAPCAdvanced pancreatic cancer

NLRNeutrophil-to-lymphocyte ratio

PLRPlatelet-to-lymphocytes ratio

CA19-9Carbohydrate antigen 19-9

CEACarcinoembryonic antigen

CRPC-reactive protein

LDHLactate dehydrogenase

TBTotal bilirubin

ASTAspartate transaminase

ALTAlanine transaminase

ALPAlkaline phosphatase

ECOG PSEastern Cooperative Oncology Group performance status

GPSGlasgow Prognostic Score

CTComputed tomography

MRIMagnetic resonance imaging

OSOverall survival

HRHazard ratio

CIConfidence interval

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Autor: Peng Xue - Lifei Zhu - Zhiyong Wan - Weiyi Huang - Ning Li - Donghui Chen - Jiong Hu - Haiyan Yang - Liwei Wang

Fuente: https://link.springer.com/







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