A combined prediction model for biliary tract cancer using the prognostic nutritional index and pathological findings: a single-center retrospective study

Abstract Background The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index, and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer. Methods Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center, retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index, and overall survival was analyzed using univariate and multivariate analyses. A P < 0.05 was considered statistically significant. Results The median age was 75 (range 38–92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 27, distal cholangiocarcinoma; 17, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. Curative (R0) resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 min), and R1–2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.027), lymph node metastasis (P = 0.040), and tumor differentiation (P = 0.006) were independent prognostic factors in multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power. Conclusions The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic factors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis, and can be used as a novel prognostic factor in patients with biliary tract cancer.

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A Combined Prediction Model for Biliary Tract Cancer using the Prognostic Nutritional Index and Pathological Findings: A Single-center Retrospective Study

10.21203/rs.3.rs-556726/v1 ◽

2021 ◽

Author(s):

Koji Kitada ◽

Naoyuki Tokunaga ◽

Takamitsu Kato ◽

Toru Narusaka ◽

Ryosuke Hamano ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Prognostic Nutritional Index ◽

Tumor Differentiation ◽

Pathological Findings ◽

Tract Cancer ◽

Node Metastasis ◽

Nutritional Index

Abstract Background: The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer.Methods: Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index and overall survival, was analyzed using univariate and multivariate analyses. P < 0.05 was considered statistically significant.Results: The median age was 75 (range, 38–92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 28, distal cholangiocarcinoma; 16, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. R0 resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 minutes), and R1–2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.007), lymph node metastasis (P = 0.024), and tumor differentiation (P = 0.008) were independent prognostic factors in the multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power.Conclusions: The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic predictors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis and can be applied as a novel prognostic indicator for patients with biliary tract cancer.

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Prognostic factor of carcinoma of the ampulla of vater after surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.270 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 270-270 ◽

Cited By ~ 1

Author(s):

Shinjiro Tomiyasu ◽

Eri Oda ◽

Hiroshi Tanaka ◽

Shinji Ishikawa ◽

Hiroki Sugita ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Tnm Stage ◽

Tract Cancer ◽

Node Metastasis ◽

Duodenal Invasion ◽

Pancreatic Invasion

270 Background: General rules for biliary tract cancer in Japan were revised and Stage of biliary tract cancer was compliant with the seventh UICC. Carcinoma of the Ampulla Vater (CAV) is relatively good prognosis among the biliary tract cancer, such as lymph node metastasis, pancreatic invasion and perineural invasion has been reported to be prognostic factors. We investigated the validity of TNM-Stage by examining the prognostic factors from the outcome of resection experienced. Methods: To evaluate prognostic factors after surgery based on a series of 70 patients of CAV from 1996 to 2014. Twenty-eight patients received pancreatoduodenectomy (PD), 25 patients received pylorus-preserving pancreatoduodenectomy (PPPD) and 17 patients received subtotal stomach-preserving pancreatoduodenectomy (SSPPD). We reviewed and analyzed the clinicopathologic data, surgical outcomes, recurrence and survival. Results: Actuarial disease-specific survival (DSS) was 65 % at five years. In univariate analysis, pancreatic invasion, lymph node metastasis and duodenal invasion are significantly poor prognosis. In multivariate analysis, pancreatic invasion is the only poor prognostic factor (p = 0.0023, hazard ratio (HR) 5.31 [confidence interval (CI) 1.77-18.9 95%]); lymph node metastasis and duodenal invasion are not significantly different (p = 0.0672 and 0.8769, respectively). Also, in the study of relapse risk factors, pancreatic invasion and lymph node metastasis are significantly different. In TNM-Stage II, those of T3N0, 1 are poor prognosis than T1, 2N1 (p = 0.0334). Conclusions: Pancreatic invasion is an independent poor prognostic and recurrence risk factor. The Stage of Japanese Society of Biliary Surgery has reflect prognosis than TNM-Stage in carcinoma of the Ampulla Vater.

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Histological features of lymph node metastasis in patients with biliary tract cancer

Journal of Surgical Oncology ◽

10.1002/jso.20963 ◽

2008 ◽

Vol 97 (5) ◽

pp. 423-427 ◽

Cited By ~ 5

Author(s):

Haruki Morimoto ◽

Tetsuo Ajiki ◽

Takashi Ueda ◽

Hidehiro Sawa ◽

Tsunenori Fujita ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Histological Features ◽

Tract Cancer ◽

Node Metastasis

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Biliary Tract Cancer at CT: A Radiomics-based Model to Predict Lymph Node Metastasis and Survival Outcomes

Radiology ◽

10.1148/radiol.2018181408 ◽

2019 ◽

Vol 290 (1) ◽

pp. 90-98 ◽

Cited By ~ 41

Author(s):

Gu-Wei Ji ◽

Yu-Dong Zhang ◽

Hui Zhang ◽

Fei-Peng Zhu ◽

Ke Wang ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Survival Outcomes ◽

Tract Cancer ◽

Node Metastasis

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Pretreatment Prognostic Nutritional Index (PNI) as a Prognostic Factor in Patients with Biliary Tract Cancer: A Meta-Analysis

Nutrition and Cancer ◽

10.1080/01635581.2020.1817955 ◽

2020 ◽

pp. 1-10

Author(s):

Xiaoyan Lv ◽

Zongxin Zhang ◽

Wenbin Yuan

Keyword(s):

Prognostic Factor ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Meta Analysis ◽

Prognostic Nutritional Index ◽

Tract Cancer ◽

Nutritional Index

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Prediction of lymph node metastasis and perineural invasion of biliary tract cancer by selected features from cDNA array data1

Journal of Surgical Research ◽

10.1016/j.jss.2004.06.003 ◽

2004 ◽

Vol 122 (2) ◽

pp. 184-194 ◽

Cited By ~ 23

Author(s):

Katsuhiko Murakawa ◽

Mitsuhiro Tada ◽

Minoru Takada ◽

Eiji Tamoto ◽

Gaku Shindoh ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Perineural Invasion ◽

Cdna Array ◽

Tract Cancer ◽

Node Metastasis

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Prediction Efficacy for Clinical Outcome of Prognostic Nutritional Index in Patients with Resectable Biliary Tract Cancer Depends on Sex and Obstructive Jaundice Status

Annals of Surgical Oncology ◽

10.1245/s10434-020-08728-8 ◽

2020 ◽

Vol 28 (1) ◽

pp. 430-438 ◽

Cited By ~ 1

Author(s):

Jie Wang ◽

Xiaobo Bo ◽

Min Li ◽

Lingxi Nan ◽

Changcheng Wang ◽

...

Keyword(s):

Clinical Outcome ◽

Obstructive Jaundice ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Prognostic Nutritional Index ◽

Tract Cancer ◽

Nutritional Index

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Value of Prognostic Nutritional Index as a Predictor of Lymph Node Metastasis in Gastric Cancer

Anticancer Research ◽

10.21873/anticanres.13901 ◽

2019 ◽

Vol 39 (12) ◽

pp. 6843-6849 ◽

Cited By ~ 1

Author(s):

TOSHIYUKI KOSUGA ◽

TOMOKI KONISHI ◽

TAKESHI KUBOTA ◽

KATSUTOSHI SHODA ◽

HIROTAKA KONISHI ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Prognostic Nutritional Index ◽

Node Metastasis ◽

Nutritional Index

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Prognostic factors in advanced biliary tract cancer treated with first-line chemotherapy with cisplatin and gemcitabine.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.350 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 350-350

Author(s):

Renata D'Alpino Peixoto ◽

Daniel John Renouf ◽

Howard John Lim

Keyword(s):

Prognostic Factors ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Primary Tumor ◽

Advanced Disease ◽

Tumor Location ◽

Primary Tumor Location ◽

Tract Cancer ◽

Ecog Ps ◽

Line Chemotherapy

350 Background: Data regarding prognostic factors in advanced biliary tract cancer (ABTC) remains scarce. The aim of this study was to review our experience in ABTC as well as to evaluate potential prognostic factors for overall survival (OS) as defined in the ABC-02 trial. Methods: 106 consecutive patients with ABTC who initiated palliative chemotherapy with Cisplatin and Gemcitabine from 2009 to 2012 at the BC Cancer Agency were identified using our pharmacy database. Clinicopathologic variables and treatment outcome were retrospectively collected. Potential prognostic factors were assessed by univariate (Kaplan-Meier curves and log-rank test) and multivariate analyses (Cox proportional hazards model). Results: 106 patients (46 males) with a median age of 64 years (range 43 – 88) were included. Median progression free-survival (PFS) was 6.2 months (95%CI: 5.4-7.0). Median OS from diagnosis of advanced disease to death was 12.9 months (95%CI: 10.0-15.7), while median OS from initiation of chemotherapy to death was 10.0 months (95%CI: 7.3-12.6). 34.9% of the patients received 2nd line chemotherapy, with single-agent 5-fluorouracil being the most used drug. On univariate analysis, ECOG performance status (PS) at diagnosis, primary tumor location (gallbladder, intra-hepatic cholangiocarcinoma, extra-hepatic cholangiocarcinoma, ampulla of Vater, unkown), and sites of advanced disease (unresectable locally advanced, regional lymph nodes, liver-limited metastases, extra-hepatic metastases) were significantly associated with worse OS (p < 0.001, 0.003 and 0.009, respectively). Age, gender, CA19-9, CEA, hemoglobin, neutrophil count, prior stent and prior surgery were not significantly associated with OS. On multivariate analysis, predictors of poorer OS were ECOG PS (p<0.001), primary location (p=0.009), site of advanced disease (p=0.006) and CEA (p=0.002). Conclusions: In this population based analysis, outcomes for patients with ABTC were comparable to those noted in the ABC-02 trial. ECOG PS, primary tumor location, site of advanced disease and CEA were all found to be significantly prognostic.

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