Evaluation of Prognostic Factors in Patients with Relapse and Unresectable Biliary Tract Cancer, Treated with S-1 after Failure of Gemcitabine

Abstract

Prognostic factors for patients with relapse and unresectable biliary tract cancer, treated with Tegafur Gimeracil Oteracil Potassium (S-1) after failure of gemcitabine (GEM), are unclear. We searched for prognostic factors in patients with relapse and unresectable biliary tract cancer treated with S-1 after failure of GEM, and investigated the relationship between prognostic factors, and the therapeutic eŠect of S-1. We retrospectively analyzed data of 33 patients with relapse and unresectable biliary tract cancer treated with S-1 after failure of GEM treatment. Statistically signiˆcant prognostic factors were extracted using Cox's proportional hazard model. Data was also collected on prognostic factors prior to the ˆrst dose of S-1, ˆnal prescription of S-1, and end of treatment. Changes in prognostic factors before the ˆrst dose of S-1, at ˆnal prescription of S-1, and at the end of treatment were evaluated using the Friedman test. Multivariate analysis identiˆed neutrophil-lymphocyte ratio (NLR) [hazard ratio (HR) ＝ 4.599, p ＝ 0.004] and prognostic nutritional index (PNI) (HR ＝ 4.985, p ＝ 0.004) as independent poor prognostic factors for overall survival. Regarding the relationship between the therapeutic eŠect and prognostic factors, a signiˆcant change was observed in the change in PNI value from ˆrst administration of S-1 to the end of treatment (p ＝ 0.002). NLR and PNI are suggested to be prognostic factors in patients with relapse and unresectable biliary tract cancer, treated with S-1 after failure of GEM. Changes in PNI from the start of administration of S-1 may be related to therapeutic e‹cacy.