Biliary tract cancer: A large institutional experience.
Bibliographic record
Abstract
288 Background: Biliary tract cancers (BTCs) encompass both cholangiocarcinoma (CC), arising in the intrahepatic, perihilar (klatskin), or distal biliary tree, ampulla of vater and gallbladder carcinoma (GBC). The prognosis is poor for the majority of these patients (pts). Given the rarity of BTC compared with other solid tumours, there have been few large studies looking at long-term outcomes. The aim of this study was to retrospectively review outcomes of pts who presented to a multidisciplinary team at Princess Margaret Hospital, Toronto, with a diagnosis of BTC. Methods: 950 pts with a diagnosis of BTC were followed from diagnosis to death between Jan 1987 and Sept 2011. Complete demographics, performance status, disease site, histological diagnosis, percentage receiving surgery with curative intent, other treatments and overall survival were analysed. Results: The cohort includes 497 (52%) males, performance status of 0-1 in 781 (82%) and 2-3 in 68 (7%) pts. A histological diagnosis of adenocarcinoma was confirmed in 806 (85%), 104 (11%) were non diagnostic, 40 (4%) other. Definitive surgery was performed in 42% and adjuvant chemotherapy (CT) or concurrent CT/radiotherapy given in only 7% and 4% respectively. The overall survival for the entire cohort of 950 pts was 18 months (mo) with survival for breakdown of tumour type detailed in table. At this time 319 (34%) pts are still alive, 561 (59%) are deceased and status is unknown in 70 (7%). CT or concurrent CT/radiotherapy was given for unresectable or metastatic disease in the first line palliative setting in 332 (35%) and 23 pts (2%) respectively. The response to first line CT in GB was 46% vs. 31% in CC and med survival was 12.2 and 11.2 mo respectively. Conclusions: This represents a large biliary cancer cohort with survival benchmarks obtained in the modern era of multidisciplinary care. The different sub-sites clearly have different prognosis. Responses and survival for advanced disease on CT are similar for GBC and CC. Updated data will be presented. [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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".