Some clinical factors are known to be associated with the survival of patients with advanced biliary tract cancer (BTC). A comprehensive model based on these variables is necessary for prediction of an individual's survival and appropriate patient counseling.
A nomogram for predicting 1-year survival in patients with advanced BTC in the palliative chemotherapy setting was developed using clinical data from 222 patients with advanced or recurrent BTC who had received first-line systemic chemotherapy from 2006 to 2017 at The University of Tokyo Hospital (Baseline Nomogram). For 214 patients whose initial response to chemotherapy is known, another nomogram (ChemoResponse-based Nomogram) was constructed using the response to chemotherapy as additional variable. Nomogram performance in terms of discrimination and calibration ability was evaluated using the C statistic.
Two different nomograms were developed and subjected to internal validation. The baseline nomogram incorporated 8 baseline clinical variables (age, sex, performance status, tumor location, disease status, CEA, CA19-9, and modified Glasgow prognostic score), whereas the chemoresponse-based nomogram was composed of 9 variables including initial response to chemotherapy evaluated by RECIST ver1.1. Internal validation revealed good performance of the two nomograms in discrimination: C statistics of 0.685 for the baseline and 0.734 for the chemoresponse-based nomogram, which showed better discrimination performance than the baseline nomogram.
This study suggests that individual 1-year survival probability of patients receiving first-line systemic chemotherapy for advanced or recurrent BTC can be reliably predicted by a nomogram-based method incorporating clinical variables and initial response to chemotherapy.
Clinical trial identification
Legal entity responsible for the study
The ethical committee of The University of Tokyo.
Has not received any funding.
All authors have declared no conflicts of interest.