Landmark survival analysis and impact of anatomic origin in prospective clinical trials of biliary tract cancer
AuthorsMcNamara, Mairead G
Knox, J. J.
Wagner, A. D.
Jensen, L. H.
Valle, Juan W
AffiliationDivision of Cancer Sciences, The University of Manchester and The Christie NHS Foundation Trust, Manchester M20 4BX,
MetadataShow full item record
AbstractBACKGROUND: Inclusion of all patients with advanced biliary tract cancer (aBTC), irrespective of anatomic location, in prospective trials, is debated. Survival rates from landmark analysis offer more relevant information once patients have survived for some time. AIM: assess survival impact of BTC anatomic site origin and landmark survival (LS). PATIENTS AND METHODS: Patients enrolled into prospective first-line aBTC clinical trials were included. OS was analysed using Cox-proportional-hazard-regression; LS and 95% confidence intervals (CIs) were calculated. RESULTS: Overall: 1333 patients included (Jan 97-Dec 15); median age 63-years (range 23-85); 46%-male; 84%-ECOG-PS0/1; 25%-locally-advanced (LA), 72%-metastatic, 3%-not reported (NR); gallbladder-(GBC): 385 (29%), cholangiocarcinoma not-specified-(CCA-NS): 363 (27%), extrahepatic-(EHC): 247 (19%), intrahepatic-(IHC): 209 (16%), ampulla: 53 (4%), 76 (6%) NR. Treatment was mono-chemotherapy: 310-(23%), cisplatin/gemcitabine: 482-(36%), other combination: 520-(39%), NR: 21-(2%). Median OS: 10.2-months (95%-CI 9.6-10.9). All sites (treatment-adjusted) had decreased risk of death vs GBC: EHC-(P<.001), IHC-(P<.002), CCA-NS-(P<.003), ampulla-(P=.003). This reduced risk vs GBC was maintained in those receiving cisplatin/gemcitabine in EHC-(P<.001) and IHC-(P<.001), but not in CCA-NS-(P=.82) or ampulla-(P=.96). Probabilities of surviving an additional year given survival to 1, 2, 3, and 4 years post-trial registration were 37%, 45%, 61%, and 63% respectively. For patients who survived 1 year; those receiving combination therapy vs mono (P=.008) (acknowledging potential selection bias), and those with IHC and CCA-NS vs GBC had better LS (both P<.05). Metastatic stage vs LA was associated with shorter LS (P=.002). ECOG-PS and gender had no evidence of effect on LS (P.05
CitationM. G. McNamara, A. Lopes, H. Wasan et al. Landmark survival analysis and impact of anatomic origin in prospective clinical trials of biliary tract cancer. J Hepatol. 2020.
JournalJournal of Hepatology
- Gemcitabine-based chemotherapy for advanced biliary tract carcinomas.
- Authors: Abdel-Rahman O, Elsayed Z, Elhalawani H
- Issue date: 2018 Apr 6
- Radiotherapy or Chemoradiation in Unresectable Biliary Cancer: A Retrospective Study.
- Authors: Bisello S, Buwenge M, Palloni A, Autorino R, Cellini F, Macchia G, Deodato F, Cilla S, Brandi G, Tagliaferri L, Cammelli S, Valentini V, Morganti AG, Mattiucci GC
- Issue date: 2019 Jun
- Prognosis and prognostic factors in patients with advanced biliary tract cancer depending on its anatomical location.
- Authors: Song BG, Park JK, Kim HS, Kim K, Park JK, Lee KH, Lee KT, Lee JK
- Issue date: 2019 Jun
- The role of surgery and adjuvant therapy in lymph node-positive cancers of the gallbladder and intrahepatic bile ducts.
- Authors: Tran Cao HS, Zhang Q, Sada YH, Chai C, Curley SA, Massarweh NN
- Issue date: 2018 Jan 1
- Landscape of distant metastasis mode and current chemotherapy efficacy of the advanced biliary tract cancer in the United States, 2010-2016.
- Authors: Wang J, Bo X, Nan L, Wang CC, Gao Z, Suo T, Ni X, Liu H, Lu P, Wang Y, Liu H
- Issue date: 2020 Feb