Risk estimation for biliary tract cancer: Development and validation of a prognostic score
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Risk estimation for biliary tract cancer: Development and validation of a prognostic score. / Schweitzer, Nora; Fischer, Mareike; Kirstein, Martha M; Berhane, Sarah; Kottas, Martina; Sinn, Marianne; Gonzalez-Carmona, Maria A; Balta, Zeynep; Weismüller, Tobias J; Strassburg, Christian P; Reineke-Plaaß, Tanja; Bektas, Hüseyin; Manns, Michael P; Johnson, Philip; Weinmann, Arndt; Vogel, Arndt.
In: LIVER INT, Vol. 37, No. 12, 12.2017, p. 1852-1860.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Risk estimation for biliary tract cancer: Development and validation of a prognostic score
AU - Schweitzer, Nora
AU - Fischer, Mareike
AU - Kirstein, Martha M
AU - Berhane, Sarah
AU - Kottas, Martina
AU - Sinn, Marianne
AU - Gonzalez-Carmona, Maria A
AU - Balta, Zeynep
AU - Weismüller, Tobias J
AU - Strassburg, Christian P
AU - Reineke-Plaaß, Tanja
AU - Bektas, Hüseyin
AU - Manns, Michael P
AU - Johnson, Philip
AU - Weinmann, Arndt
AU - Vogel, Arndt
N1 - © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2017/12
Y1 - 2017/12
N2 - BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.
AB - BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.
KW - Aged
KW - Biliary Tract Neoplasms/diagnosis
KW - Cholangiocarcinoma/diagnosis
KW - Cohort Studies
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Risk Assessment
U2 - 10.1111/liv.13517
DO - 10.1111/liv.13517
M3 - SCORING: Journal article
C2 - 28695669
VL - 37
SP - 1852
EP - 1860
JO - LIVER INT
JF - LIVER INT
SN - 1478-3223
IS - 12
ER -
