Prognostic Factors for Advanced Pancreatic Cancer Treated with Gemcitabine Plus S-1: Retrospective Analysis and Development of a Prognostic Model
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristic and GS Treatment Duration
2.2. Survival and Prognostic Score
2.3. Performance of the Prognostic Model
3. Discussion
4. Materials and Methods
4.1. Patients and Treatment
4.2. Data Collection and Follow-Up
4.3. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristic | Value (%) |
---|---|
Median age, year (range) | 62 (32–82) |
Male sex | 66 (59.5) |
Median BMI, kg/m2 (range) | 22.5 (15.6–32.5) |
ECOG PS | |
0 or 1 | 89 (80.2) |
2 | 19 (17.1) |
3 | 3 (2.7) |
Charlson comorbidity index | |
0 | 31 (27.9) |
1 | 39 (35.1) |
2 | 21 (18.9) |
3 | 17 (15.3) |
4 | 2 (1.8) |
5 | 1 (0.9) |
Smoking | |
never | 56 (50.5) |
ever or active | 55 (49.5) |
Primary tumor site | |
head | 32(28.8) |
body | 24 (21.6) |
tail | 32 (28.8) |
overlapping | 23 (20.7) |
Presence of jaundice | |
No | 84 (75.7) |
Yes | 27 (24.3) |
Primary tumor size, cm (range) | 4.9 (1.8–13.1) |
T-classification | |
1 | 2 (1.8) |
2 | 14 (12.6) |
3 | 30 (27.0) |
4 | 65 (58.6) |
N-classification | |
0 | 19 (17.1) |
1 | 92 (82.9) |
M-classification | |
0 | 22 (19.8) |
1 | 89 (80.2) |
AJCC tumor stage | |
III | 22 (19.8) |
IV | 89 (80.2) |
Site of metastases | |
liver | 57 (51.4) |
peritoneum | 31 (27.9) |
distant lymph nodes | 17 (15.3) |
lung | 13 (11.7) |
others | 4 (3.6) |
Variable | Category | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | ||
Age | per year | 1.02 (0.99–1.04) | 0.14 | ||
BMI | per kg/m2 | 0.97 (0.91–1.04) | 0.41 | ||
Sex | male | 1 | 1 | ||
female | 0.68 (0.44–1.06) | 0.090 | 0.71 (0.42–1.20) | 0.200 | |
ECOG PS | 0 or 1 | 1 | 1 | ||
2 | 2.95 (1.70–5.12) | <0.001 | 1.43 (0.74–2.77) | 0.29 | |
3 | 4.58 (1.41–14.9) | 0.011 | 15.0 (3.11–72.6) | 0.001 | |
CCI | per index | 1.15 (0.94–1.40) | 0.17 | ||
Smoking | never | 1 | |||
ever | 1.39 (0.90–2.15) | 0.16 | |||
Tumor site | head | 1 | 1 | ||
body | 0.75 (0.39–1.44) | 0.40 | 1.58 (0.73–3.42) | 0.250 | |
tail | 1.77 (1.01–3.08) | 0.045 | 1.85 (0.96–3.59) | 0.090 | |
overlapping | 1.14 (0.60–2.15) | 0.69 | 1.95 (0.93–4.06) | 0.080 | |
Presence of jaundice | no | 1 | |||
yes | 1.35 (0.80–2.25) | 0.26 | |||
Primary tumor size | per cm | 1.08 (0.94–1.25) | 0.15 | ||
T-classification | 1 | 1 | |||
2 | 1.74 (0.23–13.4) | 0.600 | |||
3 | 1.14 (0.15–8.45) | 0.90 | |||
4 | 0.60 (0.081–4.44) | 0.62 | |||
N-classification | 0 | 1 | |||
1 | 1.57 (0.90–2.73) | 0.19 | |||
M-classification | 0 | 1 | 1 | ||
1 | 4.57 (2.19–9.54) | <0.001 | 5.13 (2.05–12.8) | 0.001 | |
Hemoglobin, g/dL | >12 | 1 | |||
≤12 | 1.39 (0.58–2.17) | 0.14 | |||
Platelet count, 109/L | ≥150 | 1 | |||
<150 | 0.99 (0.57–1.71) | 0.99 | |||
Leukocyte count, 109/L | <11,000 | 1 | |||
≥11,000 | 1.36 (0.93–2.11) | 0.18 | |||
AST, U/L | ≤34 | 1 | |||
>34 | 1.02 (0.65–1.60) | 0.93 | |||
Alkaline phosphatase, IU/L | ≤140 | 1 | |||
>140 | 1.43 (0.91–2.24) | 0.13 | |||
CEA, ng/mL | ≤5 | 1 | |||
>5 | 1.16 (0.75–1.79) | 0.51 | |||
CA19-9, u/mL | ≤37 | 1 | |||
>37 | 0.87 (0.52–1.46) | 0.60 | |||
Albumin, g/dL | per gm/dL | 0.52 (0.33–0.84) | 0.008 | 0.58 (0.33–0.98) | 0.043 |
NLR | per ratio | 1.15 (1.07–1.23) | <0.001 | 1.20 (1.11–1.31) | <0.001 |
Factor | β | SE | p | Hazard Ratio | 95% CI |
---|---|---|---|---|---|
ECOG PS | |||||
0 or 1 | Reference | ||||
2 | 0.359 | 0.337 | 0.286 | 1.432 | 0.74–2.77 |
3 | 2.709 | 0.804 | 0.001 | 15.0 | 3.11–72.6 |
Tumor stage | |||||
III | reference | ||||
IV | 1.636 | 0.469 | 0.001 | 5.13 | 2.05–12.9 |
NLR, 100% | 0.186 | 0.044 | <0.001 | 1.204 | 1.11–1.31 |
Albumin, g/dL | −0.547 | 0.282 | 0.043 | 0.579 | 0.33–0.98 |
Constant | 3 | 0.911 | 0.001 | 0.041 | - |
Prognostic Group | Prognostic Score | N (%) | Median Survival, Months (95% CI) | Hazard Ratio (95% CI) | p Value |
---|---|---|---|---|---|
Good | < 2.7 | 36 (32.4) | 21.1 (8.2–33.9) | 1 (reference) | |
Intermediate | 2.7 to 3.3 | 33 (29.7) | 9.2 (8.3–10.1) | 2.80 (1.55–5.06) | 0.001 |
Poor | >3.3 | 42 (37.8) | 5.8 (4.4–7.1) | 4.81 (2.71–8.56) | <0.001 |
Patient | ECOG PS | Stage | Neutrophil | Lymphocyte | NLR | Albumin (g/dL) | Sum of Scores | Prognostic Group |
---|---|---|---|---|---|---|---|---|
A | 0 | III | 60 | 20 | 3 | 4.0 | 1.37 | good |
B | 0 | IV | 60 | 15 | 4 | 4.0 | 2.916 | intermediate |
C | 3 | IV | 60 | 12 | 5 | 3.0 | 3.634 | poor |
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Chang, C.-F.; Huang, P.-W.; Chen, J.-S.; Chen, Y.-Y.; Lu, C.-H.; Chang, P.-H.; Hung, Y.-S.; Chou, W.-C. Prognostic Factors for Advanced Pancreatic Cancer Treated with Gemcitabine Plus S-1: Retrospective Analysis and Development of a Prognostic Model. Cancers 2019, 11, 57. https://doi.org/10.3390/cancers11010057
Chang C-F, Huang P-W, Chen J-S, Chen Y-Y, Lu C-H, Chang P-H, Hung Y-S, Chou W-C. Prognostic Factors for Advanced Pancreatic Cancer Treated with Gemcitabine Plus S-1: Retrospective Analysis and Development of a Prognostic Model. Cancers. 2019; 11(1):57. https://doi.org/10.3390/cancers11010057
Chicago/Turabian StyleChang, Ching-Fu, Pei-Wei Huang, Jen-Shi Chen, Yen-Yang Chen, Chang-Hsien Lu, Pei-Hung Chang, Yu-Shin Hung, and Wen-Chi Chou. 2019. "Prognostic Factors for Advanced Pancreatic Cancer Treated with Gemcitabine Plus S-1: Retrospective Analysis and Development of a Prognostic Model" Cancers 11, no. 1: 57. https://doi.org/10.3390/cancers11010057