A Prognostic Model to Predict Clinical Outcomes with First-Line Gemcitabine-Based Chemotherapy in Advanced Pancreatic Cancer

Yi, Jun; Lee, Jeeyun; Park, Se Hoon; Lee, Kyu Taek; Lee, Jong Kyun; Lee, Kwang Hyuck; Choi, Dong Wook; Choi, Seong Ho; Heo, Jin Seok; Lim, Do Hoon; Park, Young Suk; Lim, Ho Yeong; Kang, Won Ki; Park, Keunchil; Park, Joon Oh

doi:10.1159/000328449

Cited by 32 publications

(34 citation statements)

References 43 publications

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“…Previous studies have established reduced serum albumin as a marker of poor prognosis in cancer patients [6,7,9,[13][14][15] and also of a patient's capacity to endure aggressive cancer therapy [16,17]. A reduced albumin level has previously been attributed to the consuming nature of the cancer [3,7].…”

Section: Discussionmentioning

confidence: 99%

Association Between Decreased Serum Albumin With Risk of Venous Thromboembolism and Mortality in Cancer Patients

et al. 2016

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Background. In cancer patients, reduced serum albumin has been described as a marker for global declining health and poor prognosis. Our aim was to investigate the association of albumin concentrations with the occurrence of venous thromboembolism (VTE) and mortality in patients with cancer. Methods. This investigation was performed in the framework of the Vienna Cancer and Thrombosis Study (CATS), a prospective observational cohort study. We included 1,070 patients with active cancer and assayed serum albumin from venous blood taken at study inclusion. Risk for occurrence of VTE was calculated in a proportional subdistribution hazard regression model with respect to competing risk of death and adjusted for cancer site, leukocyte count, estimated glomerular filtration rate, and cholinesterase.

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Section: Discussionmentioning

confidence: 99%

Association Between Decreased Serum Albumin With Risk of Venous Thromboembolism and Mortality in Cancer Patients

et al. 2016

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“…Therefore, limited studies have focused on metastatic disease [3,4]. A previous Korean study reported liver metastasis, peritoneal seeding, high CRP, and low serum albumin as poor indicators of OS.…”

Section: Discussionmentioning

confidence: 99%

“…However, the role of these parameters is not affirmed, and the risk of bias subsists when the choice of cutoff for the continuous variables is random, leading to the use of different cutoff points across multiple studies, which impedes direct comparison. In addition, regarding advanced disease which is unresectable or metastatic, few risk scoring indices were available, and the majority focused on prediction after chemotherapy—particularly gemcitabine [4]. However, it is more important in the clinical field to discriminate patients who might benefit from chemotherapy from those who cannot.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Scoring Index for Patients with Metastatic Pancreatic Adenocarcinoma

et al. 2016

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PurposeThis study focused on implementation of a prognostic scoring index based on clinico-laboratory parameters measured routinely on admission in metastatic pancreatic cancer patients.Materials and MethodsRecords from 403 patients of metastatic disease were analyzed retrospectively. Continuous variables were dichotomized according to the normal range or the best cut-off values statistically determined by Contal and O’Quigley method, and then analyzed in association with prognosis—overall survival (OS), using Cox’s proportional hazard model. Scores were calculated by summing the rounded chi-square scores for the factors that emerged in the multivariate analysis.ResultsPerformance status, hemoglobin, leucocyte count, neutrophil-lymphocyte ratio, and carcinoembryonic antigen were independent factors for OS. When patients were divided into three risk groups according to these factors, median survival was 11.7, 6.2, and 1.3 months for the low, intermediate, and high-risk groups, respectively (p < 0.001). Palliative chemotherapy has a significant survival benefit for low and intermediate-risk patients (median OS; 12.5 months vs. 5.9 months, p < 0.001 and 8.0 months vs. 2.0 months, p < 0.001, respectively).ConclusionWe advocate the use of a multivariable approach with continuous variables for prognostic modeling. Our index is helpful in accurate patient risk stratification and may aid in treatment selection.

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“…28, 29, 31 Each of those factors independently decreases survival by about 3 to 4 weeks, and these factors may help clinicians recommend specific therapies based on the presence of these factors in a given patient.…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Randomized Trials: Immediate Stent Placement vs. Surgical Bypass in the Palliative Management of Malignant Biliary Obstruction

Glazer

Hornbrook

Krouse

2014

Journal of Pain and Symptom Management

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Context Many patients with unresectable pancreatic and peripancreatic cancer require treatment for malignant biliary obstruction. We performed a meta-analysis of randomized trials comparing immediate biliary stent placement and immediate surgical biliary bypass in patients with unresectable pancreatic and peripancreatic cancer. Objectives To conduct a meta-analysis of the English language literature (1985 through 2011) comparing those two treatments and analyze hospital utilization patterns. Methods After identifying five randomized controlled trials comparing immediate biliary stent placement and immediate surgical biliary bypass, we performed a meta-analysis for dichotomous outcomes, using a random effects model. We compared resource utilization in terms of the number of hospital days before death, by reviewing high-quality literature. Results 379 patients were identified. We found no statistically significant differences in success rates between the two treatments (risk ratio [RR], 0.99; 95% confidence interval [CI], 0.93 to 1.05, P = 0.67). Major complications and mortality were not significantly higher after surgical bypass (RR, 1.54; 95% CI, 0.87 to 2.71; P = 0.14). Recurrent biliary obstruction was significantly less frequent after surgical bypass than after stent placement (RR, 0.14; 95% CI, 0.03–0.63; P < 0.01). Despite similar overall survival rates, longer survival was associated with more hospital days before death in stent patients than in surgical patients. Conclusions Nearly all patients with unresectable pancreatic cancer benefit from some procedure to manage biliary obstruction. Patients with low surgical risk may benefit more from surgery because the risk of recurrence and subsequent hospital utilization are much lower than for stent patients.

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A Prognostic Model to Predict Clinical Outcomes with First-Line Gemcitabine-Based Chemotherapy in Advanced Pancreatic Cancer

Cited by 32 publications

References 43 publications

Association Between Decreased Serum Albumin With Risk of Venous Thromboembolism and Mortality in Cancer Patients

Association Between Decreased Serum Albumin With Risk of Venous Thromboembolism and Mortality in Cancer Patients

Prognostic Scoring Index for Patients with Metastatic Pancreatic Adenocarcinoma

A Meta-Analysis of Randomized Trials: Immediate Stent Placement vs. Surgical Bypass in the Palliative Management of Malignant Biliary Obstruction

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