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Ann Surg Oncol. 2018 Jul;25(7):1889-1895. doi: 10.1245/s10434-018-6485-7. Epub 2018 Apr 24.

A Novel Physiobiological Parameter-Based Grading System for Resectable Pancreatic Cancer.

Author information

1
Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi-City, Kochi, Japan. tokabaya@gmail.com.
2
Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi-City, Kochi, Japan.
3
Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
4
Department of Radiology, Kochi Health Sciences Center, Kochi, Japan.
5
Department of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan.
6
Department of Biostatistics, Kochi Medical School, Kochi, Japan.

Abstract

BACKGROUND:

Preoperative methods to estimate disease-specific survival (DSS) for resectable pancreatic cancer are limited.

OBJECTIVE:

The aim of this study was to develop and validate a pretreatment physiobiological prognostic model in patients with radiologically resectable pancreatic cancer.

METHODS:

A retrospective review of a prospectively maintained institutional database was undertaken to identify patients who underwent potentially curative resection for radiologically resectable pancreatic cancer. Demographics, treatments, and relationships between the potential prognostic factors and survival rate were analyzed, and prognostic nomograms were established.

RESULTS:

We identified 240 patients who fulfilled our eligible criteria. The 1-, 3-, and 5-year DSS rates after surgery were 77.8, 40.9, and 31.3%, respectively. On multivariate analysis, increased neutrophil/lymphocyte ratio [hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.17-2.17; p < 0.01], reduced Prognostic Nutritional Index (HR 2.08, 95% CI 1.68-3.20; p < 0.01), and elevated preoperative serum carbohydrate antigen 19-9 level (HR 2.12, 95% CI 1.55-2.88; p < 0.01) were associated with worse DSS. Although curative resection was the operative aim for all patients, 131 (54.6%) patients had recurrence within 12 months after curative resection of resectable pancreatic cancer. There was a significant correlation between recurrence pattern and physiobiological characteristics.

CONCLUSION:

We developed a new grading system for radiologically resectable pancreatic cancer. This system is simple and reliably predicts differences in survival after pancreatic resection.

PMID:
29691738
DOI:
10.1245/s10434-018-6485-7
[Indexed for MEDLINE]

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