Cancer Res Treat.  2016 Oct;48(4):1253-1263. 10.4143/crt.2015.400.

Prognostic Scoring Index for Patients with Metastatic Pancreatic Adenocarcinoma

• Park HS
• Lee HS
• Park JS
• Park JS
• Lee DK
• Lee SJ
• Yoon DS
• Lee MG
• Jeung HC

• KMID: 2356227
• DOI: http://doi.org/10.4143/crt.2015.400

Abstract

PURPOSE
This study focused on implementation of a prognostic scoring index based on clinico-laboratory parameters measured routinely on admission in metastatic pancreatic cancer patients.
MATERIALS AND METHODS
Records from 403 patients of metastatic disease were analyzed retrospectively. Continuous variables were dichotomized according to the normal range or the best cut-off values statistically determined by Contal and O'Quigley method, and then analyzed in association with prognosis"”overall survival (OS), using Cox's proportional hazard model. Scores were calculated by summing the rounded chi-square scores for the factors that emerged in the multivariate analysis.
RESULTS
Performance status, hemoglobin, leucocyte count, neutrophil-lymphocyte ratio, and carcinoembryonic antigen were independent factors for OS. When patients were divided into three risk groups according to these factors, median survival was 11.7, 6.2, and 1.3 months for the low, intermediate, and high-risk groups, respectively (p < 0.001). Palliative chemotherapy has a significant survival benefit for low and intermediate-risk patients (median OS; 12.5 months vs. 5.9 months, p < 0.001 and 8.0 months vs. 2.0 months, p < 0.001, respectively).
CONCLUSION
We advocate the use of a multivariable approach with continuous variables for prognostic modeling. Our index is helpful in accurate patient risk stratification and may aid in treatment selection.

Keyword

Pancreatic neoplasms; Prognosis; Research design; Survival

MeSH Terms

Adenocarcinoma*
Carcinoembryonic Antigen
Drug Therapy
Humans
Methods
Multivariate Analysis
Pancreatic Neoplasms
Prognosis
Proportional Hazards Models
Reference Values
Research Design
Retrospective Studies
Carcinoembryonic Antigen

Figure

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  Fig. 1. Kaplan-Meier curves of overall survival for all patients (n=403) according to neutrophil-to-lymphocyte ratio (NLR) (A), C-reactive protein (CRP) (B), carcinoembryonic antigen (CEA) (C), and carbohydrate antigen 19-9 (CA 19-9) (D).

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  Fig. 2. Kaplan-Meier overall survival curves according to risk group. Patients were classified according to three risk groups based on prognostic prediction score: low risk, 0-6; intermediate risk, 7-25; and high risk, 26-28.

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  Fig. 3. Kaplan-Meier overall survival survival curves according to palliative treatment in the low-risk (A), intermediate-risk (B), and high-risk (C) groups.

Reference

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