Baseline anemia in patients with biliary tract cancer (BTC) and its association with survival: A retrospective cohort study.
Bibliographic record
Abstract
426 Background: The prognostic significance of anemia in BTC is unknown, but is common and may be multifactorial; data regarding its causes are limited. This study interrogated a large institutional database to examine the effect of anemia on overall survival (OS) in BTC, and explore factors associated with anemia. Methods: This Princess Margaret Cancer Centre cohort study included patients with BTC with available baseline hemoglobin (Hb) (1987-2016). Anemia was defined as Hb < 132 mg/dL for men > 60 years, < 137mg/dL for men aged 20-59, and < 122mg/dL in women. Additional relevant covariates were included in multivariable Cox regression for OS, and linear regression for association with Hb. Results: Of 1398 patients included, 711 (51%) were anemic at baseline (mean Hb 112 mg/dL). Anemic versus non-anemic patients were older (median age 66 vs 64 yrs, p = 0.006), had worse ECOG PS (12% ECOG 2-3 vs 6%, p < .001), BMI < 20 (31% vs 27%, p = 0.006) and elevated neutrophil:lymphocyte ratio (NLR), (64% vs 47%, p < .001), but cancer staging was not significantly different. Anemia was associated with shorter OS on univariate (HR 1.35, p < .001) and multivariable (HR 1.39, p < .001) regression (Table). Factors associated with lower Hb included older age, male gender, worse ECOG PS, tumor site, thrombocytopenia, elevated NLR. Conclusions: Baseline anemia was associated with shorter survival following diagnosis of BTC, independent of tumor stage or ECOG PS. Clinicians should be aware of this prognostic marker; validation in prospective datasets is warranted. [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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".