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吉西他滨联合顺铂一线治疗晚期肝内胆管癌患者生存的预后因素

Prognostic Factors for Survival in Patients with Advanced Intrahepatic Cholangiocarcinoma Treated with Gemcitabine plus Cisplatin as First-Line Treatment.

作者信息

Ishimoto Utako, Kondo Shunsuke, Ohba Akihiro, Sasaki Mitsuhito, Sakamoto Yasunari, Morizane Chigusa, Ueno Hideki, Okusaka Takuji

机构信息

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Oncology. 2018;94(2):72-78. doi: 10.1159/000480703. Epub 2017 Oct 11.

Abstract

OBJECTIVES

Intrahepatic cholangiocarcinoma (ICC) is a rare type of liver cancer. No clinically useful prognostic factors have been reported for patients with advanced ICC. In the present study, we aimed to evaluate the clinical prognostic factors of patients with advanced ICC receiving gemcitabine plus cisplatin combination therapy (GC) as standard first-line chemotherapy.

METHODS

A retrospective analysis was performed of the data of patients with ICC treated at our institution from March 2011 to January 2016. We used the Cox regression model and estimated the hazard ratios of potential prognostic factors for survival.

RESULTS

Of 216 patients with biliary tract cancer receiving GC as first-line chemotherapy, we extracted data for 77 patients who were diagnosed with ICC and received GC as first-line chemotherapy. The median overall survival was 13.8 months (95% CI, 8.9-18.6). In multivariate analysis, pretreatment serum lactate dehydrogenase (hazard ratio [HR]: 2.53, p = 0.005), C-reactive protein (HR: 3.06, p = 0.001), and carcinoembryonic antigen (HR: 2.39, p = 0.03) levels were significantly associated with overall survival.

CONCLUSIONS

Readily available clinical laboratory values reliably predicted the prognosis of ICC patients receiving GC therapy. If validated in other studies, these results may provide a useful tool for individual patient-risk evaluation and the design and interpretation of future trials.

摘要

目的

肝内胆管癌(ICC)是一种罕见的肝癌类型。对于晚期ICC患者,尚未有临床可用的预后因素报道。在本研究中,我们旨在评估接受吉西他滨联合顺铂(GC)作为标准一线化疗的晚期ICC患者的临床预后因素。

方法

对2011年3月至2016年1月在我院接受治疗的ICC患者数据进行回顾性分析。我们使用Cox回归模型,并估计潜在预后因素对生存的风险比。

结果

在216例接受GC作为一线化疗的胆管癌患者中,我们提取了77例被诊断为ICC并接受GC作为一线化疗患者的数据。中位总生存期为13.8个月(95%CI,8.9 - 18.6)。多因素分析显示,治疗前血清乳酸脱氢酶(风险比[HR]:2.53,p = 0.005)、C反应蛋白(HR:3.06,p = 0.001)和癌胚抗原(HR:2.39,p = 0.03)水平与总生存期显著相关。

结论

易于获得的临床实验室值可可靠地预测接受GC治疗的ICC患者的预后。如果在其他研究中得到验证,这些结果可能为个体患者风险评估以及未来试验的设计和解读提供有用的工具。

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