Risk estimation for biliary tract cancer: development and validation of a prognostic score

Nora Schweitzer; Mareike Fischer; Martha M Kirstein; Sarah Berhane; Martina Kottas; Marianne Sinn; Maria A Gonzalez-Carmona; Zeynep Balta; Tobias J Weismüller; Christian P Strassburg; Tanja Reineke-Plaaß; Hüseyin Bektas; Michael P Manns; Philip Johnson; Arndt Weinmann; Arndt Vogel

doi:10.1111/liv.13517

Risk estimation for biliary tract cancer: development and validation of a prognostic score

Nora Schweitzer, Mareike Fischer, Martha M Kirstein, Sarah Berhane, Martina Kottas, Marianne Sinn, Maria A Gonzalez-Carmona, Zeynep Balta, Tobias J Weismüller, Christian P Strassburg, Tanja Reineke-Plaaß, Hüseyin Bektas, Michael P Manns, Philip Johnson, Arndt Weinmann, Arndt Vogel

Applied Health Research

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.

METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.

RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.

CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.

Original language	English
Pages (from-to)	1852-1860
Number of pages	9
Journal	Liver International
Volume	37
Issue number	12
Early online date	11 Jul 2017
DOIs	https://doi.org/10.1111/liv.13517
Publication status	Published - Dec 2017

Bibliographical note

Keywords

Aged
Biliary Tract Neoplasms/diagnosis
Cholangiocarcinoma/diagnosis
Cohort Studies
Female
Germany/epidemiology
Humans
Male
Middle Aged
Prognosis
Risk Assessment

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/liv.13517

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Schweitzer, N., Fischer, M., Kirstein, M. M., Berhane, S., Kottas, M., Sinn, M., Gonzalez-Carmona, M. A., Balta, Z., Weismüller, T. J., Strassburg, C. P., Reineke-Plaaß, T., Bektas, H., Manns, M. P., Johnson, P., Weinmann, A., & Vogel, A. (2017). Risk estimation for biliary tract cancer: development and validation of a prognostic score. Liver International, 37(12), 1852-1860. https://doi.org/10.1111/liv.13517

@article{2b19ed3fe98440c8b880cb79c968453c,

title = "Risk estimation for biliary tract cancer: development and validation of a prognostic score",

abstract = "BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.",

keywords = "Aged, Biliary Tract Neoplasms/diagnosis, Cholangiocarcinoma/diagnosis, Cohort Studies, Female, Germany/epidemiology, Humans, Male, Middle Aged, Prognosis, Risk Assessment",

author = "Nora Schweitzer and Mareike Fischer and Kirstein, {Martha M} and Sarah Berhane and Martina Kottas and Marianne Sinn and Gonzalez-Carmona, {Maria A} and Zeynep Balta and Weism{\"u}ller, {Tobias J} and Strassburg, {Christian P} and Tanja Reineke-Plaa{\ss} and H{\"u}seyin Bektas and Manns, {Michael P} and Philip Johnson and Arndt Weinmann and Arndt Vogel",

note = "{\textcopyright} 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2017",

month = dec,

doi = "10.1111/liv.13517",

language = "English",

volume = "37",

pages = "1852--1860",

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issn = "1478-3223",

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Schweitzer, N, Fischer, M, Kirstein, MM, Berhane, S, Kottas, M, Sinn, M, Gonzalez-Carmona, MA, Balta, Z, Weismüller, TJ, Strassburg, CP, Reineke-Plaaß, T, Bektas, H, Manns, MP, Johnson, P, Weinmann, A & Vogel, A 2017, 'Risk estimation for biliary tract cancer: development and validation of a prognostic score', Liver International, vol. 37, no. 12, pp. 1852-1860. https://doi.org/10.1111/liv.13517

TY - JOUR

T1 - Risk estimation for biliary tract cancer

T2 - development and validation of a prognostic score

AU - Schweitzer, Nora

AU - Fischer, Mareike

AU - Kirstein, Martha M

AU - Berhane, Sarah

AU - Kottas, Martina

AU - Sinn, Marianne

AU - Gonzalez-Carmona, Maria A

AU - Balta, Zeynep

AU - Weismüller, Tobias J

AU - Strassburg, Christian P

AU - Reineke-Plaaß, Tanja

AU - Bektas, Hüseyin

AU - Manns, Michael P

AU - Johnson, Philip

AU - Weinmann, Arndt

AU - Vogel, Arndt

PY - 2017/12

Y1 - 2017/12

N2 - BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.

AB - BACKGROUND & AIMS: Biliary tract cancer is a rare tumour entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival.METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analysed. A prognostic model defining three prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centres.RESULTS: Median overall survival (OS) was 14.5 months. If complete resection was performed, the patients had a significantly improved OS (23.9 months; n=242) as compared to patients with non-resectable tumours (9.1 months; n=329, P<.0001). Based on univariable and multivariable analyses of clinical data, a prognostic model was created using variables available before treatment. Those were age, metastasis, C-reactive protein (CRP), international normalized ratio (INR) and bilirubin. The prognostic score distinguished three groups with a median OS of 21.8, 8.6 and 2.6 months respectively. The validation cohort had a median OS of 20.2, 14.0 and 6.5 months respectively. The prognostic impact of the score was independent of the tumour site and of treatment procedures.CONCLUSIONS: Here, we identified prognostic factors and propose a prognostic score to estimate survival, which can be applied to all patients independent of tumour site and before initial treatment. Further validation in prospective trials is required.

KW - Aged

KW - Biliary Tract Neoplasms/diagnosis

KW - Cholangiocarcinoma/diagnosis

KW - Cohort Studies

KW - Female

KW - Germany/epidemiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Risk Assessment

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U2 - 10.1111/liv.13517

DO - 10.1111/liv.13517

M3 - Article

C2 - 28695669

SN - 1478-3223

VL - 37

SP - 1852

EP - 1860

JO - Liver International

JF - Liver International

IS - 12

ER -

Risk estimation for biliary tract cancer: development and validation of a prognostic score

Abstract

Bibliographical note

Keywords

UN SDGs

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