Neutrophil/lymphocyte ratio as a prognostic factor in biliary tract cancer

2014 ◽  
Vol 50 (9) ◽  
pp. 1581-1589 ◽  
Author(s):  
M.G. McNamara ◽  
A.J. Templeton ◽  
M. Maganti ◽  
T. Walter ◽  
A.M. Horgan ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tract Cancer

Neutrophil/lymphocyte ratio (NLR) may predict prognostic factor with gemcitabine, cisplatin (GC) for patients with advanced biliary tract cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 410-410
Author(s):  
Toru Otsuru ◽  
Daisuke Sakai ◽  
Akie Kimura ◽  
Chiaki Inagaki ◽  
Naohiro Nishida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Bile Duct ◽  
Prognostic Factor ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Intrahepatic Bile Duct ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tract Cancer

410 Background: There is little information available about prognostic markers of GC (gemcitabine, cisplatin) in patients with advanced biliary tract cancer (BTC). Neutrophil/lymphocyte ratio (NLR) in several cancers was might to be a prognostic factor associated with clinical outcomes, we examine NLR in patient with BTC underwent chemotherapy (GC). Methods: Retrospective chart review for consecutive patients who underwent GC for advanced BTC in our institute were performed. The patients who were enrolled in ongoing clinical trials were excluded. Gemcitabine and cisplatin were administered intravenously at doses of 1,000 or 25 mg/m2, on day one and eight, every three weeks. We divided these patients based on estimated NLR, and evaluated the clinicopathological factors and survival in the two groups (NLR ≥ 3 or < 3). Results: 57 patients from 2013 to 2017 were reviewed. 23 patients were in NLR ≥ 3 group and 34 patients were in NLR < 3 group. Patients characteristics were as follows; median age, 68 years old (range: 38-83) years: male 36 (63%); primary tumor lesion, intrahepatic bile duct 6 (10%)/extrahepatic bile duct 32 (56%)/gallbladder 18 (32%)/ampulla of vater 1 (2%); therapeutic purpose, palliative 50 (88%)/adjuvant 5 (8%)/neoadjuvant 2 (4%); PS, 0/1. Response rate of the patients who had measurable lesion according to RECIST v1.1 was 17% (8/46), and disease control rate was 70% (32/46). The progression-free survival rate between the two groups is not significantly different. Although, the median overall survival (OS) of NLR ≥ 3 group was 11.8 months, while OS of NLR < 3 group was 29.2 months. The overall survival rate in the NLR ≥ 3 group was significantly lower than that in the NLR < 3 group ( P = 0.0339). Conclusions: Our study confirmed that high NLR is associated with worse OS and PFS, and suggested it may be a predictive marker for GC chemotherapy in patients with BTC.

Neutrophil/lymphocyte ratio (NLR) may predict prognostic factor with gemcitabine/cisplatin/S-1 (GCS) for patients with advanced biliary tract cancer (MITSUBA /KHBO1401-1B).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15656-e15656
Author(s):  
Toru Otsuru ◽  
Tatsuya Ioka ◽  
Hiroaki Nagano ◽  
Etsuro Hatano ◽  
Hidetoshi Eguchi ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Progression Free Survival ◽  
Predictive Marker ◽  
Roc Curves ◽  
Phase Iii ◽  
Phase Iii Trial ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tract Cancer

e15656 Background: There is little information available about prognostic markers of gemcitabine, cisplatin, and S-1 (GCS) in patients with advanced biliary tract cancer (aBTC). Neutrophil/lymphocyte ratio (NLR) in several cancers including aBTC was reported to be a prognostic and/or predictive factor associated with clinical outcomes. There are no data about relation between NLR and clinical outcome in patient with aBTC who underwent GCS. Methods: Baseline demographics and NLR at enrollment were retrospectively evaluated in 119 patients who received GCS treatment in MITSUBA / KHBO1401 randomized phase III trial, which showed significant superiority of GCS to GC. The clinical utility of the NLR was evaluated by receiver operating characteristic (ROC) curves, and the cutoff values for NLR were 3.7. We divided these patients based on estimated NLR, and evaluated the clinicopathological factors and survival in the two groups (NLR ≧ 3.7 or < 3.7). Results: 32 patients were in NLR ≧ 3.7group and 87 patients were in NLR < 3.7 group. The progression-free survival between two groups was not significantly different (p = 0.45). Although, the median overall survival (OS) of NLR ≧ 3.7 group was 10.4 months, while OS of NLR < 3.7 group was 18.5 months (HR 0.55, 95% confidential interval [CI] 0.36-0.87; p = 0.01).The ratio that was able to continue chemotherapy from initial administration six months later was 83.4%of NLR < 3.7 group, and 65.6% of NLR ≧ 3.7 group (p = 0.04). Conclusions: Our study confirmed that high NLR is associated with worse OS, and suggested it may be a predictive marker for GCS chemotherapy in patients with aBTC.

scholarly journals Risk Stratification in Advanced Biliary Tract Cancer: Validation of the A.L.A.N. Score

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lukas Müller ◽  
Aline Mähringer-Kunz ◽  
Florian Jungmann ◽  
Yasemin Tanyildizi ◽  
Fabian Bartsch ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Significant Risk ◽  
Minor Component ◽  
Neutrophil To Lymphocyte Ratio ◽  
Brier Score ◽  
Clinical Registry ◽  
Lymphocyte Ratio ◽  
Tract Cancer

Background. In addition to the clinical parameters, immune-inflammatory markers have emerged as prognostic factors in patients with advanced biliary tract cancer (ABC). The recently proposed A.L.A.N. score combines both in an easily applicable manner. The aim of this study was to perform the first external evaluation of this score. Methods. All patients from our clinical registry unit who had unresectable ABC underwent first-line chemotherapy from 2006 to 2018 and met the inclusion criteria of the original study were included (n =  74). The A.L.A.N. score comprises the following parameters: actual neutrophil count, lymphocyte-to-monocyte ratio, albumin, and neutrophil-to-lymphocyte ratio (A.L.A.N.). Univariate and multivariate hazard regression analyses were performed to evaluate the score’s parameters regarding overall survival (OS). The concordance index (C-index) and integrated Brier score (IBS) were calculated to evaluate the score’s predictive performance. Results. Low, intermediate, and high A.L.A.N. scores corresponded to median OS of 21.9, 11.4, and 4.3 months, respectively, resulting in a significant risk stratification (log-rank p=0.017). In multivariate analysis, a high-risk A.L.A.N. score remained an independent predictor of poor survival (p=0.016). Neutrophil-to-lymphocyte ratio was not a significant factor for poor OS in the analyses in the cohort. The score’s ability to predict individual patient survival was only moderate with a C-index of 0.63. Conclusions. The A.L.A.N. score can be used to identify risk groups with a poor prognosis prior to the start of chemotherapy. However, the ability of the score to predict individual patient outcome was only moderate; thus, it may only serve as a minor component in the complex interdisciplinary discussion.

Preoperative Neutrophil-to-lymphocyte Ratio Predicts Tumor-infiltrating CD8+ T Cells in Biliary Tract Cancer

2020 ◽  
Vol 40 (5) ◽  
pp. 2881-2887
Author(s):  
RYOTA TANAKA ◽  
KENJIRO KIMURA ◽  
SHINPEI EGUCHI ◽  
JUN TAUCHI ◽  
MASATUNE SHIBUTANI ◽  
...  
Keyword(s):  
T Cells ◽  
Biliary Tract ◽  
Cd8 T Cells ◽  
Biliary Tract Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tract Cancer

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.

scholarly journals Real-World Evidence on Palliative Gemcitabine and Oxaliplatin (GemOx) Combination Chemotherapy in Advanced Biliary Tract Cancer

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3507
Author(s):  
Hanna Lagenfelt ◽  
Hakon Blomstrand ◽  
Nils O. Elander
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Real World ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Real Life ◽  
Phase Iii ◽  
Combination Regimen ◽  
Neutrophil Lymphocyte Ratio ◽  
Tract Cancer

Background: Gemcitabine and oxaliplatin (GemOx) is a standard combination regimen in advanced biliary tract cancer (BTC). There is limited evidence on its efficacy and safety in real life. Methods: A retrospective multicentre cohort study in the South East Region of Sweden, covering nine years (2011–2020) and three hospitals where GemOx was treatment of choice, was designed. Clinicopathological prognostic parameters were explored. Results: One hundred and twenty-one patients with advanced BTC were identified. Median overall and progression-free survival (OS and PFS) were 8.9 (95% CI = 7.2–10.6) and 5.3 (95% CI = 3.8–6.7) months. Performance status according to Eastern Cooperative Oncology Group (PS according to ECOG) 1–2 and primary gallbladder carcinoma were independent predictors for poor OS. PS and derived neutrophil/lymphocyte ratio were predictive for PFS. The most common severe type of myelosuppresion was grade 3 neutropenia that was recorded in 8%. Fifty-three (43.8%) experienced at least one episode of unplanned hospitalisation. One hundred and seventeen (97%) received oxaliplatin with lower dosage than was utilized in previous phase III trials (80–85 vs. 100 mg/m2) and a majority received further dose reductions of oxaliplatin and/or gemcitabine. Conclusion: The outcome of GemOx in advanced BTC appears comparable in controlled trials and real-world contexts. A lower dose of oxaliplatin seems more tolerable without compromising the outcome.

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