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Prognostic Index of Park et al for Advanced Biliary Tract Adenocarcinoma

Purpose: To evaluate a patient with advanced biliary tract adenocarcinoma using the prognostic index of Park et al.

Description

Park et al developed a prognostic index (PI) for patients with advanced biliary tract adenocarcinoma. This can help to identify patients who may benefit from more aggressive management or therapy with novel regimens. The authors are from the University of Ulsan in Seoul, South Korea.


Sites included:

(1) intrahepatic cholangiocarcinoma

(2) gallbladder cancer

(3) extrahepatic bile duct carcinoma

(4) cancer at the Ampulla of Vater

 

Parameters:

(1) metastases

(2) origin intra vs extra hepatic

(3) liver metastases

(4) ECOG performance status (from 0 to 4)

(5) serum alkaline phosphatase in IU/L (reference range 40 to 120 IU/L)

 

Parameter

Finding

Points

metastases

absent (locally aggressive)

0

 

present

1

primary site

extrahepatic

0

 

intrahepatic

1

liver metastases

absent

0

 

present

1

 

PI =

= (0.42 * (points for any metastases)) + (0.31 * (points for origin)) + 0.61 * (points for liver metastases)) + (0.54 * (ECOG)) + (0.001 * (alkaline phosphtase))

 

Interpretation:

• minimum PI: 0

• maximum PI: > 4, depends on serum alkaline phosphatase

 

PI

Risk Group

Overall Survival

<= 1.5

low

11.5 months

1.51 to 2.2

intermediate

7.3 months

> 2.2

high

3.6 months

 


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Specialty

Objective

ICD-10