Skeletal muscle depletion to predict survival of patients with advanced biliary tract cancer undergoing palliative chemotherapy.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 460-460
Author(s):  
Kyoung Min Cho ◽  
Do-Youn Oh ◽  
Tae Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Weight ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Palliative Chemotherapy ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Tract Cancer

460 Background: Reports regarding sarcopenia as a prognostic factor in advanced biliary tract cancer (BTC) are rare. Furthermore, no study has investigated the dynamics of body weight with body muscle mass as a prognostic factor in advanced BTC patients undergoing palliative chemotherapy. Hence, we investigated whether sarcopenia affects survival in patients with BTC, with a co-analysis of body weight loss and body mass index (BMI). Methods: We consecutively enrolled patients with advanced BTC who received palliative chemotherapy between 2003 and 2013. Total muscle cross-sectional area (cm2) at the L3 level assessed by computed tomography was analyzed. We defined sarcopenia as a skeletal muscle index (SMI) < 48.5 cm2/m2 (men) and < 39.5 cm2/m2(women) using ROC curves. Results: The proportion of patients with sarcopenia upon diagnosis was 52.4% and 42.2% for men and women, respectively. By multivariate analysis, sarcopenia at diagnosis and decreased SMI during chemotherapy ( P = 0.008 and P < 0.001, respectively) were poor prognostic factors for overall survival (OS). Subgroup analysis revealed that sarcopenic patients who were overweight or obese (BMI ≥ 25 kg/m2) showed worse OS ( P < 0.001). Additionally, patients with both decreased BMI and SMI during chemotherapy had worse OS ( P < 0.001). Furthermore, patients with decreased SMI had shorter survival regardless of change in BMI. However, for patients with SMI maintained during chemotherapy, decreased BMI had no effect on survival ( P = 0.576). Conclusions: Sarcopenia, sarcopenic obesity and muscle depletion during palliative chemotherapy are meaningful prognostic factors in advanced BTC. Considering muscle depletion with weight change could help to more accurately predict prognosis of patients with BTC.

scholarly journals Skeletal muscle depletion predicts survival of patients with advanced biliary tract cancer undergoing palliative chemotherapy

Oncotarget ◽  
2017 ◽  
Vol 8 (45) ◽  
pp. 79441-79452 ◽  
Author(s):  
Kyoung-Min Cho ◽  
Hyunkyung Park ◽  
Do-Youn Oh ◽  
Tae-Yong Kim ◽  
Kyung Hun Lee ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Palliative Chemotherapy ◽  
Tract Cancer

Change of skeletal muscle index during the chemotherapy as a prognostic factor of survival in pancreatic cancer patients receiving palliative chemotherapy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 363-363
Author(s):  
Younak Choi ◽  
Tae Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
Do-Youn Oh ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Palliative Chemotherapy ◽  
Cross Sectional ◽  
Poor Prognostic Factor ◽  
Skeletal Muscle Index ◽  
Korean People ◽  
Muscle Cross Sectional Area

363 Background: Body composition has emerged as a prognostic factor in cancer patients. We investigated whether sarcopenia at the diagnosis and progressive loss of skeletal muscle were associated with survival in pancreatic cancer (PC) patients receiving palliative chemotherapy. Methods: We retrospectively reviewed PC patients receiving palliative chemotherapy between 2003 and 2010. Skeletal muscle cross-sectional area at L3 was measured by computed tomography. Sarcopenia was defined using the previously published sex-specific cutoff points for Korean people. Loss of skeletal muscle was classified by sex-specific cutoffs from ROC curve. Results: Among 484 patients, 260 (53.7%) patients were more than sixty years old and 295 (61.0%) patients were male. Overall, 187 (38.6%) patients were sarcopenic at the diagnosis (male, <49.2cm2/m2; female, <31.1 cm2/m2). Decreased skeletal muscle index (SMI) during the chemotherapy, which was defined as a reduction by more than 0.21 for male and by more than 2.19 for female, was observed in 198 (77.3%) male patients and 61 (38.1%) female patients. Decreased body mass index (BMI) by more than 1 was observed in 149 patients (37.3%) without difference between genders. Median overall survival (OS) of whole patients was 8.4 months [95%CI 7.6-9.2]. In the multivariate analysis, sarcopenia (p=0.001), decreased SMI (p=0.003), and decreased BMI (p=0.001) was significantly poor prognostic factors for OS. When we analyzed four groups by SMI and BMI changes (maintained SMI and BMI, maintained SMI and decreased BMI, decreased SMI and maintained BMI, decreased SMI and BMI), the groups with maintained SMI had longer survival than the groups with decreased SMI regardless of BMI changes. Median OS was 11.5 months with maintained SMI and 8.1 months with decreased SMI (HR 0.534 and 1, p=0.004) in decreased BMI groups and 9.9 months with maintained SMI and 8.6 months with decreased SMI (HR 1 and 1.490, p=0.002) in maintained BMI groups, respectively. The analyses separately done by gender showed similar results. Conclusions: Decrease of SMI during chemotherapy was a significantly poor prognostic factor for survival regardless of BMI changes.

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

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.

Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy

2010 ◽  
Vol 67 (4) ◽  
pp. 847-853 ◽  
Author(s):  
Takashi Sasaki ◽  
Hiroyuki Isayama ◽  
Yousuke Nakai ◽  
Osamu Togawa ◽  
Hirofumi Kogure ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Tract Cancer

scholarly journals Prognostic Factors and Scoring Model for Survival in Metastatic Biliary Tract Cancer

2017 ◽  
Vol 49 (4) ◽  
pp. 1127-1139 ◽  
Author(s):  
Hyung Soon Park ◽  
Ji Soo Park ◽  
You Jin Chun ◽  
Yun Ho Roh ◽  
Jieun Moon ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Scoring Model ◽  
Tract Cancer

scholarly journals Long term responders to palliative chemotherapy for advanced biliary tract cancer

2017 ◽  
Vol 8 (2) ◽  
pp. 352-360 ◽  
Author(s):  
Mark K. Doherty ◽  
Mairéad G. McNamara ◽  
Priya Aneja ◽  
Emma McInerney ◽  
Stephanie Moignard ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Palliative Chemotherapy ◽  
Tract Cancer

Retrospective analysis of the difference of prognosis between unresectable and recurrent biliary tract cancer: Kansai Hepatobiliary Oncology Group (KHBO) 1001.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14518-e14518
Author(s):  
Masashi Kanai ◽  
Kenji Ikezawa ◽  
Tetsuo Ajiki ◽  
Tadashi Tsukamoto ◽  
Hideyoshi Toyokawa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Patient Characteristics ◽  
Lymph Node Involvement ◽  
Tract Cancer ◽  
The Status ◽  
The Difference ◽  
Ecog Ps

e14518 Background: The difference of prognosis between patients (pts) with unresectable and recurrent biliary tract cancer (BTC) receiving chemotherapy has not been clarified although some studies reported prognostic factors of BTC. In this study, we aimed to compare the prognosis of unresectable BTC with that of recurrent BTC. We also evaluated other prognostic factors of BTC. Methods: This study retrospectively reviewed the data of 403 consecutive pts with pathologically proven unresectable or recurrent BTC who received palliative chemotherapy from 18 hospitals in Japan between April 2006 and March 2009. The 1-year survival rate and overall survival (OS) and patient characteristics were compared between unresectable and recurrent cases. Univariate and multivariate analyses were performed to identify prognostic factors. Results: 380 pts (94.3%) received chemotherapy using gemcitabine and/or S-1. The 1-year survival rate and OS were significantly better in 192 pts with recurrent BTC than 211 pts with unresectable BTC (1-year survival 57.3% vs. 43.1%, p=0.005; OS 398 days [95% confidence interval (CI) 365-430] vs. 323 days [95% CI 282-364], p=0.004). In baseline characteristics, the proportion of pts who had distant metastasis was significantly greater in recurrent BTC than unresectable BTC (77.1% vs. 66.8%, p<0.001). In contrast, lymph node involvement, biliary intervention and elevated tumor marker levels (CEA and CA19-9) were more common in pts with unresectable BTC (p<0.001). After the multivariate analysis, unresectable BTC group still demonstrated a significantly worse survival than recurrent BTC group (hazard ratio [HR] 1.44, 95% CI 1.15-1.80, p=0.002). Other statistically significant prognostic factors were ECOG PS (HR 1.49, 95% CI 1.18-1.87, p<0.001), metastatic disease (HR 1.53, 95% CI 1.20-1.97, p<0.001) and higher CEA (≥5 ng/ml) (HR 1.71, 95% CI 1.36-2.15, p<0.001). Conclusions: The status of unresectable/recurrent disease is identified as one of the prognostic factors for pts with BTC receiving chemotherapy and recommended to be used as a stratification factor in the clinical trials.

Metabolic landscape using 18F-FDG PET and its clinical significances in advanced biliary tract cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 252-252
Author(s):  
Kyoung - Min Cho ◽  
Tae Yong Kim ◽  
Do-Youn Oh ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Significant Prognostic Factor ◽  
Tract Cancer ◽  
Response To Chemotherapy ◽  
Poorly Differentiated ◽  
Primary Origin

252 Background: Metabolic landscape evaluated by 18F-FDG positron emission tomography (PET) in advanced biliary tract cancer (BTC) has not been studied. Furthermore, the clinical meanings of metabolic features have rarely been reported. We evaluated the metabolic features using 18F-FDG PET and its clinical significances in advanced BTC. Methods: We consecutively enrolled advanced BTC patientswho underwent PET prior to palliative chemotherapy between 2003 and 2013. We retrospectively evaluated the findings of PET such as SUVmax, lesion numbers, involved organ and pathologic findings and other clinical factors including response to chemotherapy, progression-free survival (PFS) and overall survival (OS). Results: A total of 106 patients were enrolled (intrahepatic cholangiocarcinoma (ICC):53, extrahepatic BTC :7, gallbladder cancer (GB Ca) :30, and ampulla of vater cancer (AoV Ca): 16 patients) ECOG PS 0-1 in 89 and PS 2 in11 patients. 52.8 % of patients received gemcitabine-based chemotherapy and 47.1% of patients received 5-FU-based chemotherapy. The SUVmax was median 7.8 (range 0-44). Fifty-four percent of patients showed higher SUVmax in metastatic lesion than primary site. The SUVmax was different according to primary origin (ICC: 9.10, extrahepatic BTC: 5.90, GB Ca : 9.10, AoV Ca :6.37, p=0.008) and histologic differentiation (well-differentiated: 4.95, moderately-differentiated :6.60, poorly-differentiated :14.50, p=0.004) Patients with a SUVmax of >7.5 had more poorly differentiated histology and more PET uptake-lesions (p < 0.05) than those with a SUVmax of <7.5. The OS and PFS of all patients were 8.3 (95% CI: 5.7 – 10.8 ) and 4.9 months (95% CI: 3.4 – 6.3), respectively. Patients with a SUVmax of <7.5 had a significantly longer OS (11.4 vs. 7.4 months, p = 0.007) and PFS (6.6 vs. 4.3 months, p = 0.024) than those with a SUVmax of >7.5. In multivariate analysis, SUVmax was also a significant prognostic factor for OS (p=0.012) and PFS (p=0.039). Conclusions: Metabolic landscapes of advanced BTC are different according to primary origin and histology. This metabolic feature such as SUVmax could be a potential prognostic factor for OS and PFS in advanced BTC.

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