A prognostic model to predict clinical outcomes with first-line gemcitabine-based chemotherapy in advanced pancreatic cancer.

Abstract

OBJECTIVE:

Our aim was to devise a prognostic model for advanced pancreatic cancer based on clinical parameters.

METHODS:

We retrospectively analyzed the medical records of 298 patients who received gemcitabine-based chemotherapy from January 1999 to November 2008.

RESULTS:

The median survival of all patients was 7 months [95% confidence interval (CI) 6.2-7.8]. Multivariate analysis revealed poor prognostic factors for overall survival such as the presence of liver metastasis [p < 0.001, hazard ratio (HR) 2.628, 95% CI 1.620-4.264], the presence of ascites or peritoneal carcinomatosis (p = 0.005, HR 1.783, 95% CI 1.194-2.661), serum C-reactive protein levels >1.2 mg/dl (p = 0.021, HR 1.568, 95% CI 1.070-2.300), and serum albumin levels <3.5 g/dl (p = 0.021, HR 1.701, 95% CI 1.085-2.667). Of 298 patients, 168 patients (56.4%) were categorized as low-risk with 0 or 1 risk factor, 80 patients (26.8%) were categorized as intermediate-risk with 2 risk factors, and 50 patients (16.8%) were categorized as high-risk with 3 or 4 risk factors. The median survival duration for the low-, intermediate-, and high-risk groups was 10.0 months (95% CI 8.7-11.3), 6.7 months (95% CI 5.7-7.7), and 4.4 months (95% CI 3.2-5.6), respectively.

CONCLUSIONS:

This prognostic model could help to select treatment for patients in clinical practice, and these risk-adapted treatment strategies should be further investigated in prospective studies in such patient populations.

• Authors: Jun Ho Yi, Jeeyun Lee, Se Hoon Park, Kyu Taek Lee, Jong Kyun Lee, Kwang Hyuck Lee, Dong Wook Choi, Seong-Ho Choi, Jin-Seok Heo, Do Hoon Lim, Young Suk Park, Ho Yeong Lim, Won Ki Kang, Keunchil Park, Joon Oh Park
• Journal: Oncology (Oncology) Vol. 80 Issue 3-4 Pg. 175-80 ( 2011) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 21701231 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Chemical References

• Antimetabolites, Antineoplastic
• Biomarkers, Tumor
• Serum Albumin
• Deoxycytidine
• C-Reactive Protein
• Gemcitabine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (therapeutic use)
• Ascites
• Biomarkers, Tumor (blood)
• C-Reactive Protein (metabolism)
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Female
• Humans
• Kaplan-Meier Estimate
• Liver Neoplasms (secondary)
• Male
• Middle Aged
• Pancreatic Neoplasms (blood, drug therapy, mortality, pathology)
• Prognosis
• Proportional Hazards Models
• ROC Curve
• Retrospective Studies
• Risk Factors
• Serum Albumin (metabolism)
• Survival Rate
• Treatment Outcome
• Gemcitabine