Prognosis Based Definition of Resectability in Pancreatic Cancer: A Road Map to New Guidelines

Annals of Surgery
Atsushi ObaMarco Del Chiaro

Abstract

To identify objective preoperative prognostic factors that are able to predict long-term survival of patients affected by PDAC. In the modern era of improved systemic chemotherapy for PDAC, tumor biology, and response to chemotherapy are essential in defining prognosis and an improved approach is needed for classifying resectability beyond purely anatomic features. We queried the National Cancer Database regarding patients diagnosed with PDAC from 2010 to 2016. Cox proportional hazard models were used to select preoperative baseline factors significantly associated with survival; final models for overall survival (OS) were internally validated and formed the basis of the nomogram. A total of 7849 patients with PDAC were included with a median follow-up of 19 months. On multivariable analysis, factors significantly associated with OS included carbohydrate antigen 19-9, neoadjuvant treatment, tumor size, age, facility type, Charlson/Deyo score, primary site, and sex; T4 stage was not independently associated with OS. The cumulative score was used to classify patients into 3 groups: good, intermediate, and poor prognosis, respectively. The strength of our model was validated by a highly significant randomization test, Log-rank tes...Continue Reading

Citations

May 15, 2020·Annals of Surgery·Atsushi ObaUNKNOWN Pancreas Club, European Pancreatic Club, Chinese Pancreatic Surgery Association, European Consortium on Minimally Invasive P
Jul 18, 2020·Annals of Surgery·Atsushi ObaUNKNOWN Pancreas Club, European Pancreatic Club, Chinese Pancreatic Surgery Association, European Consortium on Minimally Invasive P
Sep 23, 2020·International Journal of Clinical Oncology·Yueming ZhangWenhui Lou
Jan 9, 2021·Annals of Surgical Oncology·Jin HeMarco Del Chiaro
Mar 3, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Kenjiro OkadaShinya Takahashi
Oct 6, 2021·Langenbeck's Archives of Surgery·Kenjiro OkadaShinya Takahashi

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