Construction and validation of a prognostic index for patients with metastatic pancreatic adenocarcinoma

Pancreas. 2011 Apr;40(3):415-21. doi: 10.1097/MPA.0b013e3182021376.

Abstract

Objectives: To identify prognostic factors in patients with metastatic pancreatic adenocarcinoma.

Methods: The relationship between patient characteristics and outcome was examined by multivariate regression analyses of data from 409 consecutive patients with metastatic pancreatic adenocarcinoma who had been treated with a gemcitabine-containing regimen, and we stratified the patients into 3 risk groups according to the number of prognostic factors they had for a poor outcome. A validation data set obtained from 145 patients who had been treated with agents other than gemcitabine was analyzed. The prognostic index was applied the each of the patients.

Results: The multivariate regression analyses revealed that the presence of pain, peritoneal dissemination, liver metastasis, and an elevated serum C-reactive protein value significantly contributed to a shorter survival time. The patients were stratified into 3 groups according to their number of risk factors, and their outcomes of the 3 groups were significantly different. When the prognostic index was applied to the validation data set, the respective outcomes of the 3 groups were found to be significantly differed from each other.

Conclusions: Pain, peritoneal dissemination, liver metastasis, and an elevated serum C-reactive protein value are important prognostic factors for patients with metastatic pancreatic adenocarcinoma.

Publication types

  • Validation Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / therapeutic use
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Female
  • Gemcitabine
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatic Neoplasms* / drug therapy
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Gemcitabine