Abstract
Gemcitabine plus S-1 (GS) is commonly used to treat advanced pancreatic cancer (APC) in Asia. Few clinical experiments have demonstrated the clinical efficacy of GS in routine clinical practice. We aimed to identify the prognostic factors and develop a prognostic model for survival prediction in patients with APC, treated with GS. Records of 111 patients with newly diagnosed APC who received first-line palliative GS chemotherapy during 2010–2016 in Taiwan were analyzed retrospectively. Univariate and multivariate analyses were performed for the identification of prognostic factors. A prognostic model using prognosticators from the multivariate analysis was developed for survival prediction. The median overall survival (OS) for the cohort was 9.3 months (95% confidence interval [CI], 8.0–10.6). The prognostic model was constructed based on four independent prognosticators: performance status, tumor stage, pre-treatment albumin level, and neutrophil-to-lymphocyte ratio. Patients were categorized by tertiles into good, intermediate, and poor prognostic groups. The median OS values for each of these groups were 21.1 (95% CI, 8.2–33.9), 9.2 (95% CI, 8.3–10.1), and 5.8 months (95% CI, 4.4–7.1; log-rank p < 0.001), respectively. The bootstrapped corrected C-index of this model was 0.80 (95% CI, 0.71–0.89). The developed model was robust and could accurately predict survival in this population, and can assist clinicians and patients in survival discrimination and the determination of appropriate medical care goals. Additional research is needed to externally validate the model’s performance.
Highlights
Pancreatic cancer is the seventh leading cause of cancer-related death, worldwide [1], and eighth in Taiwan [2], with a five-year survival rate of 8.5% in the United States of America [1] and 6.7% in Taiwan [2]
The active agents used in the first-line treatment of advanced pancreatic cancer (APC) include 5-fluouracil [7], gemcitabine [8], gemcitabine combination with nab-paclitaxel [10], gemcitabine combination with Erlotinib [9], or the FOLFIRINOX regimen [7]
This study was performed for the evaluation of the prognostic factors associated with the Gemcitabine plus S-1 (GS) regimen in the first-line treatment of APC in Taiwan; we aimed to develop a prognostic model for the prediction of survival outcomes in patients with pancreatic cancer treated with GS
Summary
Pancreatic cancer is the seventh leading cause of cancer-related death, worldwide [1], and eighth in Taiwan [2], with a five-year survival rate of 8.5% in the United States of America [1] and 6.7% in Taiwan [2]. Owing to this disease’s unspecific symptoms and a lack of effective screening tools, most patients have advanced pancreatic cancer (APC), including locally advanced or metastatic disease, at diagnosis [3].
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