Effect of body mass index on outcomes in biliary tract cancer.
Bibliographic record
Abstract
399 Background: Biliary Tract Cancer (BTC) is associated with poor outcomes, and prognostic factors are not well documented. Body Mass Index (BMI) has been shown to correlate with survival in colon, breast, lung and prostate cancer. The effect of BMI on survival in patients with BTC is unclear. Greater understanding of prognostic markers in BTC can help with treatment decisions. Methods: Patients treated for BTC in Princess Margaret Cancer Centre between 06/1987 and 08/2014 were included for analysis. Data were collected on clinicopathologic features, BMI, and survival. Patients were separated into two groups by resectability: definitive surgery (DS) or no definitive surgery (NDS). Multivariable proportional hazards regression was used to investigate the association between variables and overall survival (OS) for DS and NDS groups. Results: 902 patients (461 DS, 441 NDS) were included, with median BMI 25.7 (range 15.5-48.7). Median OS was 48.1 months in DS patients and 11 months in NDS patients. 244 NDS patients received palliative chemotherapy (55%). BMI was prognostic for OS in DS patients. In univariate analysis, DS patients with BMI <25 had poorer outcomes than those with BMI ≥25 [HR 1.40, 95% CI 1.08-1.82, p=0.01]. In multivariable analysis, the effect of BMI in DS patients remained significant: BMI <25 was associated with poorer OS [HR 1.36, 95%CI 1.03-1.81, p=0.03]. No significant differences were found in OS in NDS patients according to BMI by univariate [HR 1.04, 95%CI 0.83-1.29, p=0.74] or multivariable analysis. Prognostic factors by multivariable analysis are summarized in the Table. Conclusions: For patients undergoing definitive surgery for BTC, BMI <25 was a poor prognostic marker independent of other known prognostic variables. Other prognostic variables from our dataset match reported literature. This study is limited by its retrospective nature, however BMI may aid patient risk stratification after DS for BTC. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".