1Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
2Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
4Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea
5Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
6Department of Internal Medicine, Seoul Municipal Boramae Hospital, Seoul, Korea
Copyright © 2017 by the Korean Cancer Association
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Response | Tumor marker decrease | Tumor marker decrease | p-value | CA 19-9 decrease | CA 19-9 decrease | p-value | CEA decrease | CEA decrease | p-value |
---|---|---|---|---|---|---|---|---|---|
< 30%a) | ≥ 30%a) | < 30% | ≥ 30% | < 30% | ≥ 30% | ||||
CR | 1 (2.3) | 1 (3.1) | < 0.001 | 1 (2.6) | 0 | < 0.001 | 0 | 1 (11.1) | < 0.001 |
PR | 3 (6.8) | 18 (56.3) | 2 (5.3) | 16 (55.2) | 4 (14.8) | 7 (77.8) | |||
SD | 22 (50.0) | 9 (28.1) | 19 (50.0) | 9 (31.0) | 13 (48.1) | 1 (11.1) | |||
PD | 9 (20.5) | 3 (9.4) | 8 (21.1) | 3 (10.3) | 6 (22.2) | 0 | |||
Not measured | 9 (20.5) | 1 (3.1) | 8 (21.1) | 1 (3.4) | 4 (14.8) | 0 |
Characteristic | No. of patients (%) (n=104) |
---|---|
Age, median (range, yr) | 59 (31-76) |
≥ 65 yr | 29 (27.9) |
Sex | |
Male | 60 (57.7) |
Female | 44 (42.3) |
Primary site | |
Intrahepatic cholangiocarcinoma | 57 (54.8) |
Gallbladder cancer | 33 (31.7) |
Extrahepatic cholangiocarcinoma | 11 (10.6) |
Ampulla of Vater cancer | 3 (2.9) |
Initial presentation | |
Relapsed | 29 (27.9) |
Locally advanced | 4 (3.8) |
Metastatic | 71 (68.3) |
Metastasis | |
Liver | 59 (56.7) |
Lymph node | 53 (51.0) |
Peritoneal seeding | 20 (19.2) |
Lung | 9 (8.7) |
Bone | 6 (5.8) |
ECOG PS | |
0 | 11 (10.6) |
1 | 89 (85.6) |
2 | 4 (3.8) |
ALP (IU/L) (n=103) | |
< 115 | 64 (62.1) |
≥ 115 | 39 (37.9) |
CEA (ng/mL) | |
< 5 | 64 (61.5) |
≥ 5 | 40 (38.5) |
CA 19-9 (U/mL) (n=103) | |
< 37 | 34 (33.0) |
≥ 37 | 69 (67.0) |
≥ 370 | 46 (44.7) |
Variable | TTP (95% CI) | p-value | OS (95% CI) | p-value |
---|---|---|---|---|
Age (yr) | ||||
< 65 | 5.0 (4.1-5.8) | 0.54 | 9.3 (6.9-11.8) | 0.72 |
≥ 65 | 6.8 (5.5-8.0) | 7.5 (3.9-11.2) | ||
Sex | ||||
Male | 5.4 (3.7-7.2) | 0.80 | 8.2 (7.0-9.3) | 0.71 |
Female | 5.4 (3.8-7.1) | 9.6 (6.2-13.1) | ||
Primary site | ||||
Intrahepatic | 5.0 (4.0-5.9) | 0.64 | 8.2 (7.0-9.4) | 0.15 |
Others | 6.3 (4.2-8.3) | 10.6 (7.5-13.7) | ||
Initial presentation | ||||
Metastatic | 5.0 (4.1-5.8) | 0.24 | 8.2 (7.0-9.3) | 0.020 |
Others | 7.0 (4.9-9.0) | 11.4 (8.7-14.1) | ||
Liver metastasis | ||||
Present | 5.4 (3.5-7.4) | 0.50 | 8.6 (7.0-10.1) | 0.22 |
Absent | 5.4 (3.7-7.2) | 8.6 (3.5-13.7) | ||
ECOG PS | ||||
0 | 9.8 (4.3-15.3) | 0.40 | 18.6 (9.3-27.8) | 0.065 |
1 | 5.3 (4.1-6.5) | 8.3 (6.8-9.8) | ||
2 | 3.6 (0.0-8.6) | 7.1 (1.2-13.1) | ||
ALP (IU/L) | ||||
≥ 115 | 3.7 (1.5-6.0) | 0.039 | 7.3 (4.6-9.9) | 0.006 |
< 115 | 6.8 (5.9-7.7) | 11.2 (8.6-13.9) | ||
CEA (ng/mL) | ||||
≥ 5 | 4.7 (3.8-5.5) | 0.015 | 7.1 (5.6-8.6) | 0.002 |
< 5 | 6.3 (4.5-8.1) | 11.2 (8.9-13.5) | ||
CEA interquartile | ||||
4th quarter | 4.4 (2.7-6.0) | 0.12 | 7.1 (5.6-8.7) | 0.001 |
3rd quarter | 6.1 (4.0-8.1) | 8.2 (5.1-11.2) | ||
2nd quarter | 6.2 (4.5-7.9) | 10.9 (6.0-15.8) | ||
1st quarter | 5.4 (2.6-8.3) | 12.0 (1.6-22.4) | ||
CA 19-9 (U/mL) | ||||
≥ 37 | 5.0 (3.7-6.3) | 0.49 | 8.2 (7.0-9.4) | 0.15 |
< 37 | 6.8 (4.6-9.0) | 11.4 (9.2-13.6) | ||
CA 19-9 interquartile | ||||
4th quarter | 5.0 (3.5-6.5) | 0.66 | 7.3 (5.7-8.8) | 0.23 |
3rd quarter | 6.1 (3.1-9.0) | 8.6 (4.2-13.0) | ||
2nd quarter | 6.2 (3.6-8.8) | 9.7 (5.3-14.2) | ||
1st quarter | 6.8 (3.0-10.5) | 10.6 (6.3-14.9) | ||
CA 19-9 (U/mL) | ||||
≥ 370 | 5.3 (3.3-7.2) | 0.51 | 7.5 (6.3-8.8) | 0.043 |
< 370 | 6.1 (4.0-8.2) | 11.2 (8.4-14.0) |
Response | Tumor marker decrease | Tumor marker decrease | p-value | CA 19-9 decrease | CA 19-9 decrease | p-value | CEA decrease | CEA decrease | p-value |
---|---|---|---|---|---|---|---|---|---|
< 30% |
≥ 30% |
< 30% | ≥ 30% | < 30% | ≥ 30% | ||||
CR | 1 (2.3) | 1 (3.1) | < 0.001 | 1 (2.6) | 0 | < 0.001 | 0 | 1 (11.1) | < 0.001 |
PR | 3 (6.8) | 18 (56.3) | 2 (5.3) | 16 (55.2) | 4 (14.8) | 7 (77.8) | |||
SD | 22 (50.0) | 9 (28.1) | 19 (50.0) | 9 (31.0) | 13 (48.1) | 1 (11.1) | |||
PD | 9 (20.5) | 3 (9.4) | 8 (21.1) | 3 (10.3) | 6 (22.2) | 0 | |||
Not measured | 9 (20.5) | 1 (3.1) | 8 (21.1) | 1 (3.4) | 4 (14.8) | 0 |
ECOG, Eastern Cooperative Oncology Group; PS, performance status; ALP, alkaline phosphatase; CEA, carcinoembryonic antigen; CA 19-9, carbohydrate antigen 19-9.
TTP, time to progression; OS, overall survival; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; PS, performance status; ALP, alkaline phosphatase; CEA, carcinoembryonic antigen; CA 19-9, carbohydrate antigen 19-9.
Values are presented as number (%). CA 19-9, carbohydrate antigen 19-9; CEA, carcinoembryonic antigen; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease. Either CA 19-9 or CEA.