Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy

Tadayuki Kou, Masashi Kanai, Michio Yamamoto, Peng Xue, Yukiko Mori, Yasushi Kudo, Akira Kurita, Norimitsu Uza, Yuzo Kodama, Masanori Asada, Michiya Kawaguchi, Toshihiko Masui, Masaki Mizumoto, Shujiro Yazumi, Shigemi Matsumoto, Kyoichi Takaori, Satoshi Morita, Manabu Muto, Shinji Uemoto, Tsutomu Chiba

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors. Methods: The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves. Results: Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors—performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil–lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows—PI = 2 (if PS 2–3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups—favorable (PI 0–1, n = 73), intermediate (PI 2–3, n = 145), and poor (PI 4–8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658. Conclusions: This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.

Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalInternational Journal of Clinical Oncology
Volume21
Issue number1
DOIs
Publication statusPublished - Feb 1 2016
Externally publishedYes

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Pancreatic Neoplasms
Drug Therapy
Survival
Carcinoembryonic Antigen
Calibration
Multivariate Analysis
Carbohydrates
Antigens

Keywords

  • Palliative chemotherapy
  • Pancreatic cancer
  • Prognostic model

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

Cite this

Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy. / Kou, Tadayuki; Kanai, Masashi; Yamamoto, Michio; Xue, Peng; Mori, Yukiko; Kudo, Yasushi; Kurita, Akira; Uza, Norimitsu; Kodama, Yuzo; Asada, Masanori; Kawaguchi, Michiya; Masui, Toshihiko; Mizumoto, Masaki; Yazumi, Shujiro; Matsumoto, Shigemi; Takaori, Kyoichi; Morita, Satoshi; Muto, Manabu; Uemoto, Shinji; Chiba, Tsutomu.

In: International Journal of Clinical Oncology, Vol. 21, No. 1, 01.02.2016, p. 118-125.

Research output: Contribution to journalArticle

Kou, T, Kanai, M, Yamamoto, M, Xue, P, Mori, Y, Kudo, Y, Kurita, A, Uza, N, Kodama, Y, Asada, M, Kawaguchi, M, Masui, T, Mizumoto, M, Yazumi, S, Matsumoto, S, Takaori, K, Morita, S, Muto, M, Uemoto, S & Chiba, T 2016, 'Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy', International Journal of Clinical Oncology, vol. 21, no. 1, pp. 118-125. https://doi.org/10.1007/s10147-015-0864-x
Kou, Tadayuki ; Kanai, Masashi ; Yamamoto, Michio ; Xue, Peng ; Mori, Yukiko ; Kudo, Yasushi ; Kurita, Akira ; Uza, Norimitsu ; Kodama, Yuzo ; Asada, Masanori ; Kawaguchi, Michiya ; Masui, Toshihiko ; Mizumoto, Masaki ; Yazumi, Shujiro ; Matsumoto, Shigemi ; Takaori, Kyoichi ; Morita, Satoshi ; Muto, Manabu ; Uemoto, Shinji ; Chiba, Tsutomu. / Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy. In: International Journal of Clinical Oncology. 2016 ; Vol. 21, No. 1. pp. 118-125.
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T1 - Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy

AU - Kou, Tadayuki

AU - Kanai, Masashi

AU - Yamamoto, Michio

AU - Xue, Peng

AU - Mori, Yukiko

AU - Kudo, Yasushi

AU - Kurita, Akira

AU - Uza, Norimitsu

AU - Kodama, Yuzo

AU - Asada, Masanori

AU - Kawaguchi, Michiya

AU - Masui, Toshihiko

AU - Mizumoto, Masaki

AU - Yazumi, Shujiro

AU - Matsumoto, Shigemi

AU - Takaori, Kyoichi

AU - Morita, Satoshi

AU - Muto, Manabu

AU - Uemoto, Shinji

AU - Chiba, Tsutomu

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background: We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors. Methods: The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves. Results: Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors—performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil–lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows—PI = 2 (if PS 2–3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups—favorable (PI 0–1, n = 73), intermediate (PI 2–3, n = 145), and poor (PI 4–8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658. Conclusions: This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.

AB - Background: We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors. Methods: The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves. Results: Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors—performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil–lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows—PI = 2 (if PS 2–3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups—favorable (PI 0–1, n = 73), intermediate (PI 2–3, n = 145), and poor (PI 4–8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658. Conclusions: This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.

KW - Palliative chemotherapy

KW - Pancreatic cancer

KW - Prognostic model

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