{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:06:34Z","timestamp":1789545994227,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this study is to explore and validate a novel prognostic index for patients with locally advanced or metastatic biliary tract cancer (BTC) treated with first\u2010line therapy with cisplatin, gemcitabine, and durvalumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective, multicenter, real\u2010world study including 712 patients in the training cohort and 646 patients in the validation cohort. Using multivariate analysis for overall survival (OS) and applying the adjustment methods of Holm\u2010Bonferroni, Benjamini\u2010Hochberg, and Hommel, the authors identified five baseline statistically significant variables: disease stage, neutrophils, carcinoembryonic antigen (CEA), and carbohydrate antigen 19\u20109 (CA 19\u20109) levels, and Eastern Cooperative Oncology Group performance status (ECOG PS). According to the HR of each variable, \u03b2 coefficients were calculated and the following formula was applied: (0.1757 * neutrophils value)\u00a0+\u00a0(0.5055 * ECOG PS)\u00a0+\u00a0(1.4037 * disease stage)\u00a0+\u00a0(0.1108 * CA 19\u20109)\u00a0+\u00a0(0.2126 * CEA). According to tertiles, the authors developed a prognostic model called the SENECA index, dividing the population into three risk groups: low\u2010risk (\u22642.14), intermediate\u2010risk (2.15\u20132.89), and high\u2010risk (&gt;2.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median OS was 23.4 months in low\u2010risk group,16.1 months in intermediate\u2010risk group, and 8.3 months in high\u2010risk group (low\u2010risk hazard ratio [HR], 0.20; intermediate\u2010risk HR, 0.36; high\u2010risk HR, 1;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). Median progression\u2010free survival was 11.0 months in low\u2010risk group (33.1%), 8.8 months in intermediate\u2010risk group (33.3%), and 5.5 months in high\u2010risk group (33.5%) (low\u2010risk HR, 0.35; intermediate\u2010risk HR, 0.55; and high\u2010risk HR, 1;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SENECA index is a practical instrument for prognostic stratification of patients with BTC receiving chemoimmunotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70601","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:43:16Z","timestamp":1789537396000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic stratification of patients with biliary tract cancer treated with chemoimmunotherapy: A retrospective multicenter real\u2010world study"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3600-0232","authenticated-orcid":false,"given":"Mara","family":"Persano","sequence":"first","affiliation":[{"name":"Department of Oncology Vita\u2010Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital  Milan Italy"},{"name":"Department of Biomedical Sciences University of Cagliari  Cagliari 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