Prognostic Scoring Index for Patients with Metastatic Pancreatic Adenocarcinoma

Abstract

PurposeThis 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 MethodsRecords 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.ResultsPerformance 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).ConclusionWe 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.

Systemic Immune-Inflammation Index and Changes of Neutrophil-Lymphocyte Ratio as Prognostic Biomarkers for Patients With Pancreatic Cancer Treated With Immune Checkpoint Blockade

“…There have been a couple of studies investigating the association between HGB and clinical outcomes of PC patients. A previous study showed that HBG was an independent factor for OS of metastatic PDAC patients ( 50 ). In addition, the study by Ruiz-Tovar et al.…”

Predicting mortality and adverse events in patients with advanced pancreatic cancer treated with palliative gemcitabine-based chemotherapy in a multicentre phase III randomized clinical trial: the APC-SAKK risk scores

“…Previous studies on patients with APC have poorly focused on the prognostic role of inflammatory markers, 11–15 or have mainly focused on predicting mortality but not toxicity. 2,3,16–18 In addition, there is great heterogeneity across APC studies in the reporting of clinical and laboratory variables and their prognostic impact. 4 In a recent expert consensus document, the main variables considered to be significantly related to prognosis in randomized controlled trials investigating first-line systemic therapy for unresectable pancreatic cancer were albumin, bilirubin, CA 19-9, disease status, performance status, pain at baseline, ALP, lactate dehydrogenase and liver metastasis, while other variables, even if not with unanimous prognostic significance, were suggested to be mandatory and recommended prognostic variables to be reported (i.e.…”

Current and future biomarkers for pancreatic adenocarcinoma

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