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Evaluation of Prognostic Factors in Patients with Relapse and Unresectable Biliary Tract Cancer, Treated with S-1 after Failure of Gemcitabine

Yakugaku Zasshi. 2022;142(9):1021-1029. doi: 10.1248/yakushi.21-00231.

ABSTRACT

Prognostic factors for patients with relapse and unresectable biliary tract cancer, treated with Tegafur Gimeracil Oteracil Potassium (S-1) after failure of gemcitabine (GEM), are unclear. We searched for prognostic factors in patients with relapse and unresectable biliary tract cancer treated with S-1 after failure of GEM, and investigated the relationship between prognostic factors, and the therapeutic effect of S-1. We retrospectively analyzed data of 33 patients with relapse and unresectable biliary tract cancer treated with S-1 after failure of GEM treatment. Statistically significant prognostic factors were extracted using Cox’s proportional hazard model. Data was also collected on prognostic factors prior to the first dose of S-1, final prescription of S-1, and end of treatment. Changes in prognostic factors before the first dose of S-1, at final prescription of S-1, and at the end of treatment were evaluated using the Friedman test. Multivariate analysis identified neutrophil-lymphocyte ratio (NLR) [hazard ratio (HR)=4.599, p=0.004] and prognostic nutritional index (PNI) (HR=4.985, p=0.004) as independent poor prognostic factors for overall survival. Regarding the relationship between the therapeutic effect and prognostic factors, a significant change was observed in the change in PNI value from first administration of S-1 to the end of treatment (p=0.002). NLR and PNI are suggested to be prognostic factors in patients with relapse and unresectable biliary tract cancer, treated with S-1 after failure of GEM. Changes in PNI from the start of administration of S-1 may be related to therapeutic efficacy.

PMID:36047214 | DOI:10.1248/yakushi.21-00231

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