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Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy

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Abstract

Background

We aimed to construct a prognostic model to predict survival in patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy using readily available pretreatment factors.

Methods

The model was constructed using data from 306 consecutive patients with APC who received palliative chemotherapy between January 2006 and March 2013. The predictive accuracy of the model was assessed using a concordance index (c-index) and calibration curves.

Results

Among the 12 potential prognostic factors investigated, multivariate analysis identified the following six independent negative prognostic factors—performance status (PS), the presence of distant metastatic disease, the status of initially unresectable disease, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level, and neutrophil–lymphocyte ratio (NLR). A prognostic index (PI) based on the coefficients of these factors was constructed as follows—PI = 2 (if PS 2–3) + 1 (if distant metastatic disease) + 1 (if initially unresectable disease) + 1 (if CEA level ≥5.0 ng/ml) + 1 (if CA 19-9 level ≥1,000 U/ml) + 2 (if NLR ≥5). The patients were classified into three prognostic groups—favorable (PI 0–1, n = 73), intermediate (PI 2–3, n = 145), and poor (PI 4–8, n = 88). The median overall survival times for each prognostic group were 16.5, 12.3, and 6.2 months, respectively (P < 0.001). Bootstrapping verified the good fitness of this model for predicting 1-year survival, and the c-index was 0.658.

Conclusions

This simple prognostic model could help clinicians to estimate survival in patients with APC who receive palliative chemotherapy.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimach, Kita-ku, Osaka, 530-8480, Japan

    Tadayuki Kou, Yasushi Kudo, Akira Kurita, Masanori Asada & Shujiro Yazumi

  2. Department of Clinical Oncology and Pharmacogenomics, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Masashi Kanai, Peng Xue & Shigemi Matsumoto

  3. Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Michio Yamamoto & Satoshi Morita

  4. Department of Translational Clinical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Yukiko Mori

  5. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Norimitsu Uza, Yuzo Kodama & Tsutomu Chiba

  6. Division of Hepatobiliary Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Michiya Kawaguchi, Toshihiko Masui, Masaki Mizumoto, Kyoichi Takaori & Shinji Uemoto

  7. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Manabu Muto

Authors
  1. Tadayuki Kou
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  2. Masashi Kanai
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  3. Michio Yamamoto
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  4. Peng Xue
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  6. Yasushi Kudo
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  7. Akira Kurita
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  15. Shigemi Matsumoto
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  19. Shinji Uemoto
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  20. Tsutomu Chiba
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Correspondence to Tadayuki Kou.

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Kou, T., Kanai, M., Yamamoto, M. et al. Prognostic model for survival based on readily available pretreatment factors in patients with advanced pancreatic cancer receiving palliative chemotherapy. Int J Clin Oncol 21, 118–125 (2016). https://doi.org/10.1007/s10147-015-0864-x

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  • DOI: https://doi.org/10.1007/s10147-015-0864-x

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