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Therapeutic outcomes and prognostic factors in unresectable gallbladder cancer treated with gemcitabine plus cisplatin

DC Field Value Language
dc.contributor.authorYou, Min su-
dc.contributor.authorRyu, Ji Kon-
dc.contributor.authorChoi, Young Hoon-
dc.contributor.authorChoi, Jin Ho-
dc.contributor.authorHuh, Gunn-
dc.contributor.authorPaik, Woo Hyun-
dc.contributor.authorLee, Sang Hyub-
dc.contributor.authorKim, Yong-Tae-
dc.date.accessioned2019-03-13T05:09:26Z-
dc.date.available2019-03-13T14:10:02Z-
dc.date.issued2019-01-05-
dc.identifier.citationBMC Cancer, 19(1):10ko_KR
dc.identifier.issn1471-2407-
dc.identifier.urihttps://hdl.handle.net/10371/147080-
dc.description.abstractBackground
Gallbladder cancer (GBC) is likely to be diagnosed at progressive stages and shows a very poor prognosis. Combination therapy with gemcitabine and cisplatin (GEMCIS) has been widely used as first-line palliative chemotherapy for advanced GBC. This study was designed to investigate the efficacy of GEMCIS and identify prognostic factors in patients with unresectable GBC.

Methods
Patients with GBC who were treated with GEMCIS from January 2008 to June 2017 in a single tertiary hospital were included. All cases of GBC were diagnosed by pathologic findings and extent of the tumour was assessed by imaging tests. Combination chemotherapy consisted of cisplatin 25 mg/m2 and gemcitabine 1000 mg/m2 intravenously on days 1 and 8 every 3 weeks. To determine factors affecting prognosis, Kaplan–Meier survival analysis, log-rank test and the Cox proportional hazard regression linear model were used. All variables with P < 0.1 in univariable analysis were included in the multivariable model.

Results
A total of 173 patients received a median of 5.3 ± 4.4 cycles of chemotherapy over 3.8 ± 3.9 months. Most of the patients (94.8%) were stage IVB at the time of diagnosis and the most common site of metastasis was the liver (42.8%). Disease control rate was 59.5%: 2 (1.2%) patients with complete response, 26 (15.0%) patients with partial response and 75 (43.4%) patients with stable disease. Overall survival (OS) and progression-free survival were 8.1 (95% confidence interval [CI], 7.1–10.2) and 5.6 (95% CI 4.5–6.8) months, respectively. Multivariable regression model indicated that metastasis to liver (hazard ratio [HR] = 1.63, 95% CI 1.11–2.40; P = 0.013), neutrophil-to-lymphocyte ratio (NLR) ≥3 (HR 1.65, 95% CI 1.09–2.49; P = 0.017), CEA ≥ 5 ng/mL (HR 1.50, 95% CI 1.02–2.19; P = 0.038), and CA19–9 ≥ 500 U/mL (HR 1.59, 95% CI 1.01–2.50; P = 0.043) were significantly associated with OS.

Conclusions
GEMCIS demonstrated a high disease control rate in patients with unresectable GBC. Factors independently related to OS were metastasis to liver, NLR ≥ 3, CEA ≥ 5 ng/mL and CA19–9 ≥ 500 U/mL.
ko_KR
dc.description.sponsorshipThis study was supported by the Seoul National University College of Medicine Research Fund (2018).ko_KR
dc.language.isoenko_KR
dc.publisherBioMed Centralko_KR
dc.subjectGallbladder neoplasmsko_KR
dc.subjectGemcitabineko_KR
dc.subjectCisplatinko_KR
dc.subjectPrognosisko_KR
dc.subjectTreatment outcomeko_KR
dc.titleTherapeutic outcomes and prognostic factors in unresectable gallbladder cancer treated with gemcitabine plus cisplatinko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor유민수-
dc.contributor.AlternativeAuthor류지곤-
dc.contributor.AlternativeAuthor최영훈-
dc.contributor.AlternativeAuthor최진호-
dc.contributor.AlternativeAuthor허건-
dc.contributor.AlternativeAuthor백우현-
dc.contributor.AlternativeAuthor이상협-
dc.contributor.AlternativeAuthor김용태-
dc.identifier.doi10.1186/s12885-018-5211-y-
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2019-01-06T04:14:34Z-
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