Abstract 711
Background
Cht is the mainstay of treatment for ABTC with median overall survival (mOS) < 12 months. Given the palliative intent of treatment, its limited survival gain and not negligible toxicities it is of paramount importance to properly select pts. Determinants of immune-inflammation are regarded as promising prognostic factors in ABTC.
Methods
Clinical and laboratory data before starting 1-line cht were evaluated in 123 pts with unresectable locally advanced and metastatic ABTC (intrahepatic, perihilar and distal cholangiocarcinoma and gallbladder cancer) treated from 1st January 2010 to 31st July 2017 at Modena Cancer Centre. Potential prognostic factors were assessed by univariate (Cox proportional hazard univariate model) and multivariate analyses (multiple Cox proportional hazard regression with the likelihood ratio test).
Results
At univariate analysis ECOG PS > 0, metastatic disease, gallbladder cancer, no previous surgery, monocht, LDH > upper limit of normal, albumine < 3.5 gr/dl, absolute neutrophil count (ANC) > 8000/µl, lymphocyte/monocyte ratio (LMR) < 2.1, neutrophil/lymphocyte ratio (NLR) > 3, platelet/lymphocyte ratio > 160, AST > 40 IU/L, gamma-glutamyl-transpeptidase > 40 IU/L, CEA > 9.5 ng/ml, CA19-9 >700 U/L were significantly associate with shorter OS. At multivariate analysis, LMR < 2.1, NLR > 3, ANC > 8000/µl, albumine < 3.5 gr/dl retained statistical significance as poor prognostic factors. By combining these four variables, three different risk groups were identified: low-risk group (0 factors), intermediate-risk group (1-2 factors) and high-risk group (3-4 factors), with mOS of 22, 12, and 5 months respectively (P < 0.001). The prognostic value of the score was indipendent from treatment procedures (doublet vs monocht) and primary tumour site (P < 0.001).
Conclusions
We developed a cost-effective and easily-available scoring system that discriminates ABTC treated with 1-line cht into three, different, statistically significant prognostic groups. It could become a useful tool to add to established factors for improving pts’ selection in daily practice.
Clinical trial identification
Legal entity responsible for the study
Massimiliano Salati.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.