Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Cancer Chemother Pharmacol. 2011 Apr;67(4):847-53. doi: 10.1007/s00280-010-1360-7. Epub 2010 Jun 20.
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.
目前尚未明确接受化疗的晚期胆道癌患者的预后因素。胆囊癌和肝内胆管癌是先前报道的预后不良的预后因素；然而，在这些先前的报告中，肿瘤体积尚未进行分析。
我们分析了 56 例连续接受吉西他滨和 S-1 联合化疗作为一线姑息性化疗的晚期胆道癌患者。评估了预后因素，包括代表实体瘤反应评估标准中肿瘤体积的基线总和最长直径（BSLD）。
通过多变量分析，年龄≥70 岁（HR 3.01，95%CI 1.25-7.31，P=0.014）和较大的 BSLD（HR 1.09，95%CI 1.01-1.18，P=0.021）是独立的不良预后的统计学显著预测因子。原发性胆道部位未被确定为预后因素（P=0.728）。BSLDs≤9.0cm 和 BSLD>9.0cm 的患者的中位生存时间分别为 18.7 个月和 8.8 个月（P=0.024）。
年龄和 BSLD 被确定为接受化疗的晚期胆道癌患者的强烈预后因素。肿瘤体积可能比晚期胆道癌的原发性胆道部位对预后更重要。
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