Prognostic Role of a New Index Tested in European and Korean Advanced Biliary Tract Cancer Patients: the PECS Index.
Biliary tract cancer
Chemotherapy
Cholangiocarcinoma
Gallbladder cancer
Prognosis
Prognostic index
Survival
Journal
Journal of gastrointestinal cancer
ISSN: 1941-6636
Titre abrégé: J Gastrointest Cancer
Pays: United States
ID NLM: 101479627
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
accepted:
26
01
2021
pubmed:
6
2
2021
medline:
10
6
2022
entrez:
5
2
2021
Statut:
ppublish
Résumé
The aim of the present study is to evaluate a new index (PECS (PsECogSii)index) influenced by PS ECOG and systemic immune-inflammation index (SII) in unresectable locally advanced or metastatic BTC patients treated with first-line chemotherapy. This multicenter, international, study was conducted on a training cohort of 130 patients and in three European and Korean validation cohorts The PECS index was calculated as ECOG × SII index (neutrophil count × platelet count/lymphocyte count). Event-time distributions were estimated using the Kaplan-Meier method and survival curves were compared using the log-rank test. In the training cohort, the median overall survival (mOS) was 13.2 months, 8.7 months, and 3.8 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 1.41; PECS-2: HR 3.23) (p < 0.0001). In the first validation cohort, the mOS was 12.8 months, 10.1 months, and 5.3 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 1.29; PECS-2: HR 2.40) (p < 0.0001). In the second validation cohort, the mOS was 21.2 months, 10.2 months, and 3.0 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 2.25; PECS-2: HR 9.00) (p < 0.0001). In the third validation cohort, the median OS was 15.5 months, 7.5 months, and 3.7 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: ref HR = 1; PECS-1: HR 2.14; PECS-2: HR 5.00) (p < 0.0001). Multivariate analysis in all cohorts confirmed the PECS index as an independent prognostic factor for OS. The easy assessment, low cost, and reproducibility make PECS index a promising tool to assess the prognosis of BTC patients in future clinical practice.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
The aim of the present study is to evaluate a new index (PECS (PsECogSii)index) influenced by PS ECOG and systemic immune-inflammation index (SII) in unresectable locally advanced or metastatic BTC patients treated with first-line chemotherapy.
METHODS
METHODS
This multicenter, international, study was conducted on a training cohort of 130 patients and in three European and Korean validation cohorts The PECS index was calculated as ECOG × SII index (neutrophil count × platelet count/lymphocyte count). Event-time distributions were estimated using the Kaplan-Meier method and survival curves were compared using the log-rank test.
RESULTS
RESULTS
In the training cohort, the median overall survival (mOS) was 13.2 months, 8.7 months, and 3.8 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 1.41; PECS-2: HR 3.23) (p < 0.0001). In the first validation cohort, the mOS was 12.8 months, 10.1 months, and 5.3 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 1.29; PECS-2: HR 2.40) (p < 0.0001). In the second validation cohort, the mOS was 21.2 months, 10.2 months, and 3.0 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: HR = 1; PECS-1: HR 2.25; PECS-2: HR 9.00) (p < 0.0001). In the third validation cohort, the median OS was 15.5 months, 7.5 months, and 3.7 months for patients with PECS-0, PECS-1, and PECS-2, respectively (PECS-0: ref HR = 1; PECS-1: HR 2.14; PECS-2: HR 5.00) (p < 0.0001). Multivariate analysis in all cohorts confirmed the PECS index as an independent prognostic factor for OS.
CONCLUSIONS
CONCLUSIONS
The easy assessment, low cost, and reproducibility make PECS index a promising tool to assess the prognosis of BTC patients in future clinical practice.
Identifiants
pubmed: 33544375
doi: 10.1007/s12029-021-00596-z
pii: 10.1007/s12029-021-00596-z
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
289-298Informations de copyright
© 2021. Springer Science+Business Media, LLC, part of Springer Nature.
Références
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.
pubmed: 30620402
doi: 10.3322/caac.21551
Hyder O, Hatzaras I, Sotiropoulos GC, et al. Recurrence after operative management of intrahepatic cholangiocarcinoma. Surgery. 2013;153(6):811–8.
pubmed: 23499016
doi: 10.1016/j.surg.2012.12.005
Zhang XF, Beal EW, Bagante F, et al. Early versus late recurrence of intrahepatic cholangiocarcinoma after resection with curative intent. Br J Surg. 2018;105(7):848–56.
pubmed: 29193010
doi: 10.1002/bjs.10676
Valle J, Wasan H, Palmer DH, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.
pubmed: 20375404
doi: 10.1056/NEJMoa0908721
Kim BJ, Hyung J, Yoo C, et al. Prognostic factors in patients with advanced biliary tract cancer treated with first-line gemcitabine plus cisplatin: retrospective analysis of 740 patients. Cancer Chemother Pharmacol. 2017a;80(1):209–15.
pubmed: 28597043
doi: 10.1007/s00280-017-3353-2
Park HS, Park JS, Chun YJ, et al. Prognostic factors and scoring model for survival in metastatic biliary tract cancer. Cancer Res Treat. 2017;49(4):1127–39.
pubmed: 28161931
pmcid: 5654150
doi: 10.4143/crt.2016.538
McNamara MG, Templeton AJ, Maganti M, et al. Neutrophil/lymphocyte ratio as a prognostic factor in biliary tract cancer. Eur J Cancer. 2014a;50(9):1581–9.
pubmed: 24630393
doi: 10.1016/j.ejca.2014.02.015
Faloppi L, Del Prete M, Casadei Gardini A, et al. The correlation between LDH serum levels and clinical outcome in advanced biliary tract cancer patients treated with first line chemotherapy. Sci Rep. 2016;6:24136.
pubmed: 27063994
pmcid: 4827080
doi: 10.1038/srep24136
Park I, Lee JL, Ryu MH, et al. Prognostic factors and predictive model in patients with advanced biliary tract adenocarcinoma receiving first-line palliative chemotherapy. Cancer. 2009a;115(18):4148–55.
pubmed: 19536892
doi: 10.1002/cncr.24472
Suzuki Y, Kan M, Kimura G, et al. Predictive factors of the treatment outcome in patients with advanced biliary tract cancer receiving gemcitabine plus cisplatin as first-line chemotherapy. J Gastroenterol. 2019;54(3):281–90.
pubmed: 30298469
doi: 10.1007/s00535-018-1518-3
Salati M, Filippi R, Vivaldi C, et al. The prognostic nutritional index predicts survival and response to first-line chemotherapy in advanced biliary cancer [published online ahead of print, 2019 Nov 27]. Liver Int. 2019; https://doi.org/10.1111/liv.14314 .
Peixoto RD, Renouf D, Lim H. A population based analysis of prognostic factors in advanced biliary tract cancer. J Gastrointest Oncol. 2014a;5(6):428–32.
pubmed: 25436121
pmcid: 4226814
Bridgewater J, Lopes A, Wasan H, et al. Prognostic factors for progression-free and overall survival in advanced biliary tract cancer. Ann Oncol. 2016a;27(1):134–40.
pubmed: 26483051
doi: 10.1093/annonc/mdv483
Fornaro L, Cereda S, Aprile G, et al. Multivariate prognostic factors analysis for second-line chemotherapy in advanced biliary tract cancer. Br J Cancer. 2014a;110(9):2165–9.
pubmed: 24714745
pmcid: 4007244
doi: 10.1038/bjc.2014.190
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883–99.
pubmed: 20303878
pmcid: 2866629
doi: 10.1016/j.cell.2010.01.025
Duffy AG, Makarova-Rusher OV, Greten TF. The case for immune-based approaches in biliary tract carcinoma. Hepatology. 2016;64(5):1785–91.
pubmed: 27177447
doi: 10.1002/hep.28635
Cools-Lartigue J, Spicer J, McDonald B, et al. Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis [published online ahead of print, 2013 Jul 1]. J Clin Invest. 2013;123(8):3446–3458.
Labelle M, Begum S, Hynes RO. Direct signaling between platelets and cancer cells induces an epithelial-mesenchymal-like transition and promotes metastasis. Cancer Cell. 2011a;20(5):576–90.
pubmed: 22094253
pmcid: 3487108
doi: 10.1016/j.ccr.2011.09.009
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008a;454(7203):436–44.
pubmed: 18650914
doi: 10.1038/nature07205
Casadei Gardini A, Scarpi E, Faloppi L, et al. Immune inflammation indicators and implication for immune modulation strategies in advanced hepatocellular carcinoma patients receiving sorafenib. Oncotarget. 2016a;7(41):67142–9.
pubmed: 27613839
doi: 10.18632/oncotarget.11565
Casadei Gardini A, Marisi G, Canale M, et al. Radiofrequency ablation of hepatocellular carcinoma: a meta-analysis of overall survival and recurrence-free survival. Onco Targets Ther. 2018;11:6555–67.
pubmed: 30323628
doi: 10.2147/OTT.S170836
Casadei Gardini A, Foschi FG, Conti F, et al. Immune inflammation indicators and ALBI score to predict liver cancer in HCV-patients treated with direct-acting antivirals. Dig Liver Dis. 2019;51(5):681–8.
pubmed: 30327251
doi: 10.1016/j.dld.2018.09.016
Casadei-Gardini A, Montagnani F, Casadei C, et al. Immune inflammation indicators in anal cancer patients treated with concurrent chemoradiation: training and validation cohort with online calculator (ARC: Anal Cancer Response Classifier) [published correction appears in Cancer Manag Res. 2019 Jun 25;11:5123]. Cancer Manag Res. 2019;11:3631–42.
pubmed: 31118786
pmcid: 6506779
doi: 10.2147/CMAR.S197349
Proctor MJ, McMillan DC, Morrison DS, Fletcher CD, Horgan PG, Clarke SJ. A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. Br J Cancer. 2012;107(4):695–9.
pubmed: 22828611
pmcid: 3419948
doi: 10.1038/bjc.2012.292
Templeton AJ, Ace O, McNamara MG, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014;23(7):1204–12.
pubmed: 24793958
doi: 10.1158/1055-9965.EPI-14-0146
Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124.
Gu L, Li H, Chen L, et al. Prognostic role of lymphocyte to monocyte ratio for patients with cancer: evidence from a systematic review and meta-analysis. Oncotarget. 2016;7(22):31926–42.
pubmed: 26942464
pmcid: 5077986
doi: 10.18632/oncotarget.7876
Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma: a propensity score-matched analysis . Sci Rep. 2016;6:39482.
pubmed: 28000729
pmcid: 5175190
doi: 10.1038/srep39482
Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212–22.
pubmed: 25271081
doi: 10.1158/1078-0432.CCR-14-0442
Prognostic factors in unresectable biliary tract cancer: a GICO (Gruppo Italiano COlangiocarcinoma) retrospective analysis. Ann Oncol. 2017.
McNamara MG, Templeton AJ, Maganti M, et al. Neutrophil/lymphocyte ratio as a prognostic factor in biliary tract cancer. Eur J Cancer. 2014b;50(9):1581–9.
pubmed: 24630393
doi: 10.1016/j.ejca.2014.02.015
Peixoto RD, Renouf D, Lim H. A population based analysis of prognostic factors in advanced biliary tract cancer. J Gastrointest Oncol. 2014b;5(6):428–32.
pubmed: 25436121
pmcid: 4226814
Bridgewater J, Lopes A, Wasan H, et al. Prognostic factors for progression-free and overall survival in advanced biliary tract cancer. Ann Oncol. 2016b;27(1):134–40.
pubmed: 26483051
doi: 10.1093/annonc/mdv483
Kim BJ, Hyung J, Yoo C, et al. Prognostic factors in patients with advanced biliary tract cancer treated with first-line gemcitabine plus cisplatin: retrospective analysis of 740 patients. Cancer Chemother Pharmacol. 2017b;80(1):209–15.
pubmed: 28597043
doi: 10.1007/s00280-017-3353-2
Fornaro L, Cereda S, Aprile G, et al. Multivariate prognostic factors analysis for second-line chemotherapy in advanced biliary tract cancer. Br J Cancer. 2014b;110(9):2165–9.
pubmed: 24714745
pmcid: 4007244
doi: 10.1038/bjc.2014.190
Park I, Lee JL, Ryu MH, et al. Prognostic factors and predictive model in patients with advanced biliary tract adenocarcinoma receiving first-line palliative chemotherapy. Cancer. 2009b;115(18):4148–55.
pubmed: 19536892
doi: 10.1002/cncr.24472
Bridgewater J, Palmer D, Cunningham D, et al. Outcome of second-line chemotherapy for biliary tract cancer. Eur J Cancer. 2013;49(6):1511.
pubmed: 23265701
doi: 10.1016/j.ejca.2012.11.024
Cereda S, Belli C, Rognone A, Mazza E, Reni M. Second-line therapy in advanced biliary tract cancer: what should be the standard? Crit Rev Oncol Hematol. 2013;88(2):368–74.
pubmed: 23786845
doi: 10.1016/j.critrevonc.2013.05.010
Park HS, Park JS, Chun YJ, et al. Prognostic factors and scoring model for survival in metastatic biliary tract cancer. Cancer Res Treat. 2017;49(4):1127–39.
pubmed: 28161931
pmcid: 5654150
doi: 10.4143/crt.2016.538
Casadei Gardini A, Scarpi E, Faloppi L, et al. Immune inflammation indicators and implication for immune modulation strategies in advanced hepatocellular carcinoma patients receiving sorafenib. Oncotarget. 2016b;7(41):67142–9.
pubmed: 27613839
doi: 10.18632/oncotarget.11565
Conroy G, Salleron J, Belle A, et al. The prognostic value of inflammation-based scores in advanced hepatocellular carcinoma patients prior to treatment with sorafenib. Oncotarget. 2017;8(56):95853–95864. Published 2017 Sep 30.
Passardi A, Scarpi E, Cavanna L, et al. Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer. Oncotarget. 2016;7(22):33210–9.
pubmed: 27120807
pmcid: 5078087
doi: 10.18632/oncotarget.8901
Wang K, Diao F, Ye Z, et al. Prognostic value of systemic immune-inflammation index in patients with gastric cancer. Chin J Cancer. 2017;36(1):75. Published 2017 Sep 12.
Wang L, Wang C, Wang J, Huang X, Cheng Y. A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma. J Cancer Res Clin Oncol. 2017;143(10):2077–86.
pubmed: 28601935
doi: 10.1007/s00432-017-2451-1
Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016;7(34):54564–71.
pubmed: 27409344
pmcid: 5342364
doi: 10.18632/oncotarget.10515
Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic immune-inflammation index, based on platelet counts and neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med. 2015;236(4):297–304.
pubmed: 26250537
doi: 10.1620/tjem.236.297
Tong YS, Tan J, Zhou XL, Song YQ, Song YJ. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer. J Transl Med. 2017;15(1):221. Published 2017 Oct 31.
Yu J, Wu X, Yu H, et al. Systemic Immune-inflammation index and circulating T-cell immune index predict outcomes in high-risk acral melanoma patients treated with high-dose interferon. Transl Oncol. 2017;10(5):719–25.
pubmed: 28710916
pmcid: 5510521
doi: 10.1016/j.tranon.2017.06.004
Labelle M, Begum S, Hynes RO. Direct signaling between platelets and cancer cells induces an epithelial-mesenchymal-like transition and promotes metastasis. Cancer Cell. 2011b;20(5):576–90.
pubmed: 22094253
pmcid: 3487108
doi: 10.1016/j.ccr.2011.09.009
Schumacher D, Strilic B, Sivaraj KK, Wettschureck N, Offermanns S. Platelet-derived nucleotides promote tumor-cell transendothelial migration and metastasis via P2Y2 receptor. Cancer Cell. 2013;24(1):130–7.
pubmed: 23810565
doi: 10.1016/j.ccr.2013.05.008
Gil-Bernabé AM, Ferjancic S, Tlalka M, et al. Recruitment of monocytes/macrophages by tissue factor-mediated coagulation is essential for metastatic cell survival and premetastatic niche establishment in mice. Blood. 2012;119(13):3164–75.
pubmed: 22327225
doi: 10.1182/blood-2011-08-376426
Chen HC, Lin HC, Liu CY, et al. Neutrophil elastase induces IL-8 synthesis by lung epithelial cells via the mitogen-activated protein kinase pathway. J Biomed Sci. 2004;11(1):49–58.
pubmed: 14730209
doi: 10.1007/BF02256548
De Larco JE, Wuertz BR, Furcht LT. The potential role of neutrophils in promoting the metastatic phenotype of tumors releasing interleukin-8. Clin Cancer Res. 2004;10(15):4895–900.
pubmed: 15297389
doi: 10.1158/1078-0432.CCR-03-0760
Houghton AM, Rzymkiewicz DM, Ji H, et al. Neutrophil elastase-mediated degradation of IRS-1 accelerates lung tumor growth. Nat Med. 2010;16(2):219–23.
pubmed: 20081861
pmcid: 2821801
doi: 10.1038/nm.2084
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008b;454(7203):436–44.
pubmed: 18650914
doi: 10.1038/nature07205
Ha H, Nam AR, Bang JH, et al. Soluble programmed death-ligand 1 (sPDL1) and neutrophil-to-lymphocyte ratio (NLR) predicts survival in advanced biliary tract cancer patients treated with palliative chemotherapy. Oncotarget. 2016 Nov 22.