Kurihara Tatsuya, Kogo Mari, Ishii Masakazu, Yoneyama Keiichiro, Kitamura Katsuya, Shimada Ken, Shimizu Shunichi, Yoshida Hitoshi, Kiuchi Yuji
Hepatogastroenterology. 2015 Mar-Apr;62(138):478-84.
BACKGROUND/AIMS: We performed this retrospective cohort study to identify prognostic factors for unresectable pancreatic cancer treated with current standard therapy using gemcitabine (GEM) or S-1 and to stratify patients prior to treatment using a prognostic index (PI).
We analyzed 182 patients with unresectable pancreatic cancer, who had received GEM or S-1 as first-line chemotherapy. Factors that contributed to the prognosis were identified by univariate and multivariate analysis using a Cox proportional hazards model. The PI was constructed using the factors identified in the multivariate analysis.
By multivariate analysis, performance status (PS), stage, and absolute neutrophil count (ANC) were identified as factors that independently contributed to the prognosis of unresectable pancreatic cancer (P < 0.05). The hazard ratios were 1.69, 3.33, and 1.18, respectively. In addition, PI was calculated using these three factors. Patients were classified into three groups according to the PI values. A significant difference was observed among the survival curves of these three groups (P < 0.05).
We identified three prognostic factors in the population after the introduction of S-1, and have created a simple and useful PI. This index demonstrates the ability to accurately classify advanced pancreatic cancer patients before the start of treatment.
背景/目的：我们进行了这项回顾性队列研究，以确定采用当前标准疗法（使用吉西他滨（GEM）或S-1）治疗的不可切除胰腺癌的预后因素，并使用预后指数（PI）在治疗前对患者进行分层。
我们分析了182例接受GEM或S-1作为一线化疗的不可切除胰腺癌患者。使用Cox比例风险模型通过单变量和多变量分析确定影响预后的因素。PI是使用多变量分析中确定的因素构建的。
通过多变量分析，体能状态（PS）、分期和绝对中性粒细胞计数（ANC）被确定为独立影响不可切除胰腺癌预后的因素（P < 0.05）。风险比分别为1.69、3.33和1.18。此外，使用这三个因素计算PI。根据PI值将患者分为三组。这三组的生存曲线之间观察到显著差异（P < 0.05）。
我们在引入S-1后的人群中确定了三个预后因素，并创建了一个简单且有用的PI。该指数显示出在治疗开始前准确分类晚期胰腺癌患者的能力。
