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[Prognostic factors in advanced pancreatic cancer. Multivariate analysis of predictive survival score. University
B Trigui1, A Barrier, A Flahault
1Service de chirurgie digestive, hôpital Tenon, Paris, France.
Study Aim:
To identify prognostic factors in advanced pancreatic cancer and to define a predictive score.
Patients And Method:
One hundred and sixty six patients were included in this multicentre study. Seventeen covariables were prospectively collected for each patient. Covariables associated with survival (p < 0.10) were analysed by a stepwise Cox model.
Results:
Four prognostic factors were selected on multivariate analysis: pain (RR 1.5; CI: 1.1-2.0), ascites (RR 1.7; CI: 1.0-2.9), weight loss > 10 kg (RR 1.4; CI: 1.0-2.0), and metastases (RR 2.3: CI: 1.6-3.2). A score was defined by attributing a value of one for pain, ascites and weight loss, and two for metastases. Patients with a score > 2 had a median survival of 2 months (SE: 0.5), and patients with a score < or = 2 had a median survival of 6 months (SE: 0.6) (Logrank p < 0.0001).
Conclusion:
The proposed score may be helpful in therapeutic decisions concerning surgery, palliative chemotherapy and/or radiotherapy. However, this score must be validated on an independent series of patients.