Wu Chiao-En, Huang Wen-Kuan, Chou Wen-Chi, Hsieh Chia-Hsun, Chang John Wen-Cheng, Lin Cheng-Yu, Yeh Chun-Nan, Chen Jen-Shi
Department of Internal Medicine, Division of Haematology-Oncology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan.
Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan.
Cancers (Basel). 2021 Jun 23;13(13):3139. doi: 10.3390/cancers13133139.
The estimation of mortality risk among patients diagnosed with advanced cancer provides important information for clinicians and patients in clinical practice. Currently, gemcitabine-based chemotherapy regimens are the standard treatment for patients with advanced biliary tract cancer (BTC). We aimed to develop a nomogram to predict the 6-month mortality rate among patients with advanced BTC to help physicians evaluate treatment options and outcomes.
We conducted a retrospective analysis to evaluate the 6-month mortality rate among patients with advanced BTC who underwent gemcitabine-based chemotherapy from 2012 to 2018. Data regarding pretreatment factors and the clinical response to treatment were collected. Univariate and multivariate analyses were performed to identify independent factors for nomogram creation.
A total of 202 advanced BTC patients who were treated with gemcitabine-based chemotherapy were included in this analysis. No difference in survival was identified between patients undergoing gemcitabine monotherapy and those treated with gemcitabine combined with other cytotoxic agents. The univariate analysis revealed 10 significant factors, while the multivariate analysis identified four independent factors, including gender, monocyte to lymphocyte ratio (MLR), alkaline phosphatase (ALP), and liver metastasis, which were used to establish the nomogram. The performance of this nomogram for the prediction of 6-month mortality risk was found to be promising and feasible based on logistic regression.
A nomogram based on four independent pretreatment factors, including gender, MLR, ALP, and liver metastasis, was established to predict the 6-month mortality risk in patients with advanced BTC; it can provide clinicians and patients with additional information when evaluating treatment outcomes.
对晚期癌症患者的死亡风险进行评估可为临床实践中的医生和患者提供重要信息。目前，以吉西他滨为基础的化疗方案是晚期胆管癌（BTC）患者的标准治疗方法。我们旨在开发一种列线图，以预测晚期BTC患者的6个月死亡率，帮助医生评估治疗方案和结果。
我们进行了一项回顾性分析，以评估2012年至2018年接受以吉西他滨为基础化疗的晚期BTC患者的6个月死亡率。收集了有关预处理因素和治疗临床反应的数据。进行单因素和多因素分析以确定列线图创建的独立因素。
本分析共纳入202例接受以吉西他滨为基础化疗的晚期BTC患者。接受吉西他滨单药治疗的患者与接受吉西他滨联合其他细胞毒性药物治疗的患者在生存率上没有差异。单因素分析显示10个显著因素，而多因素分析确定了4个独立因素，包括性别、单核细胞与淋巴细胞比率（MLR）、碱性磷酸酶（ALP）和肝转移，这些因素用于建立列线图。基于逻辑回归发现，该列线图预测6个月死亡风险的性能具有前景且可行。
建立了一种基于性别、MLR、ALP和肝转移这4个独立预处理因素的列线图，以预测晚期BTC患者的6个月死亡风险；在评估治疗结果时，它可以为临床医生和患者提供额外信息。
