Clinical Prognostic Factors and Survival Risk Stratification for Advanced Biliary Tract Cancer Treated with...

Area of Science:

• Oncology
• Clinical Medicine
• Cancer Research

Background:

• Gemcitabine-based chemotherapy is standard for advanced biliary tract cancer (BTC).
• There is a need for practical pretreatment prognostic factors in advanced BTC.
• This study aims to identify prognostic factors and develop a risk stratification for survival.

Purpose of the Study:

• Identify baseline prognostic factors for overall survival (OS) in advanced BTC patients.
• Explore a simple risk stratification approach for 12-month survival.
• Inform prognostic discussions in clinical practice.

Main Methods:

• Retrospective cohort study of 154 advanced BTC patients treated with gemcitabine-based chemotherapy (2011-2025).
• Collected baseline clinical and laboratory variables.
• Used Kaplan-Meier, univariable, and multivariable Cox regression to identify prognostic factors.
• Developed an exploratory risk score based on independent prognostic factors.

Main Results:

• Median OS was 9.43 months.
• Poor ECOG performance status (≥2), elevated alkaline phosphatase (ALP) (≥2 × ULN), and elevated neutrophil-to-lymphocyte ratio (NLR) (≥3) were associated with worse OS.
• An exploratory score stratified patients into low (59.6% 12-month OS), intermediate (40.4%), and high-risk (10.8%) groups.

Conclusions:

• Poor performance status, elevated ALP, and elevated NLR are associated with worse OS in advanced BTC patients receiving gemcitabine-based chemotherapy.
• A simple risk score using these factors shows distinct 12-month survival rates across risk groups.
• This exploratory score may aid prognostic discussions but requires external validation.