一种用于预测晚期胰腺癌患者姑息化疗后临床结局的预后指数模型。
A prognostic index model to predict the clinical outcomes for advanced pancreatic cancer patients following palliative chemotherapy.
作者信息
Xue Peng, Zhu Lifei, Wan Zhiyong, Huang Weiyi, Li Ning, Chen Donghui, Hu Jiong, Yang Haiyan, Wang Liwei
机构信息
Nanjing Medical University, Nanjing, Jiangsu, China.
出版信息
J Cancer Res Clin Oncol. 2015 Sep;141(9):1653-60. doi: 10.1007/s00432-015-1953-y. Epub 2015 Mar 20.
PURPOSE
To establish a prognostic index model for advanced pancreatic cancer patients receiving palliative chemotherapy based on clinical variables.
METHODS
The 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.
RESULTS
Median 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).
CONCLUSIONS
A novel prognostic index model based on three clinical parameters was established to predict the prognosis of patients with advanced pancreatic cancer receiving palliative chemotherapy.
目的
基于临床变量建立晚期胰腺癌患者接受姑息化疗的预后指数模型。
方法
回顾性分析2006年1月至2013年8月在本中心接受姑息化疗的118例晚期胰腺癌患者的临床资料。使用Cox比例风险模型确定总生存的预后因素。通过这些预处理因素建立预后指数模型以预测预后。采用Kaplan-Meier估计法和对数秩检验比较低风险组和高风险组患者的总生存差异。
结果
所有患者的中位总生存时间为8.8个月[95%置信区间（CI）7.0 - 10.6个月]。多因素分析确定ECOG评分为2（风险比2.03；95%CI 1.07 - 3.85；P = 0.030）、CA19 - 9水平≥1000 U/mL（风险比2.07；95%CI 1.09 - 3.92；P = 0.026）以及CRP水平≥5 mg/L（风险比2.05；95%CI 1.06 - 3.96；P = 0.033）为总生存的独立不良预后因素。对于这三个因素，ECOG评分为2、CA19 - 9水平≥1000 U/mL以及CRP水平≥5 mg/L各分配1分。共有84例（71.2%）患者被分配到低风险组，总分为0 - 1分，34例（28.8%）患者被归类为高风险组，总分为2 - 3分。低风险组和高风险组的中位总生存分别为9.9个月（95%CI 6.8 - 13.0）和5.3个月（95%CI 4.1 - 6.5）（风险比0.27；95%CI 0.14 - 0.52；P < 0.001）。低风险组和高风险组的估计1年生存率分别为40.5%和5.9%（P < 0.05）。
结论
建立了一种基于三个临床参数的新型预后指数模型，用于预测接受姑息化疗的晚期胰腺癌患者的预后。
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