Prognostic factors and scoring model for survival in Metastatic biliary tract cancer

Hyung Soon Park, Ji Soo Park, You Jin Chun, Yun Ho Roh, Jieun Moon, Hong Jae Chon, Hye Jin Choi, Joon Seong Park, Dong Ki Lee, Se Joon Lee, Dong Sup Yoon, Hei Cheul Jeung

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Purpose Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. Materials and Methods From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox's proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. Results The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia ( < 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell's C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. Conclusion These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.

Original languageEnglish
Pages (from-to)1127-1139
Number of pages13
JournalCancer Research and Treatment
Issue number4
Publication statusPublished - 2017

Bibliographical note

Funding Information:
This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (to H.C. Jeung, No. 1420060).

Publisher Copyright:
© 2017 by the Korean Cancer Association.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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