A Novel Physiobiological Parameter-Based Grading System for Resectable Pancreatic Cancer.

Area of Science:

• Oncology
• Surgical Oncology
• Cancer Prognostics

Background:

• Limited preoperative methods exist to estimate disease-specific survival (DSS) for resectable pancreatic cancer.
• Accurate prognostication is crucial for treatment planning and patient management.

Purpose of the Study:

• To develop and validate a pretreatment physiobiological prognostic model for patients with radiologically resectable pancreatic cancer.
• To identify key factors influencing disease-specific survival and recurrence.

Main Methods:

• Retrospective review of a prospectively maintained institutional database of 240 patients undergoing potentially curative resection for pancreatic cancer.
• Analysis of demographics, treatments, and physiobiological factors (neutrophil/lymphocyte ratio, Prognostic Nutritional Index, carbohydrate antigen 19-9) for association with survival.
• Development of prognostic nomograms and a new grading system.

Main Results:

• 1-, 3-, and 5-year DSS rates were 77.8%, 40.9%, and 31.3%, respectively.
• Increased neutrophil/lymphocyte ratio, reduced Prognostic Nutritional Index, and elevated preoperative carbohydrate antigen 19-9 were significantly associated with worse DSS.
• 54.6% of patients experienced recurrence within 12 months, with a correlation between recurrence pattern and physiobiological characteristics.

Conclusions:

• A novel grading system for radiologically resectable pancreatic cancer has been developed.
• This system effectively predicts survival differences post-pancreatic resection.
• The model offers a simple yet reliable tool for patient stratification and management.