Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas
Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas
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DOI：
10.1016/j.pan.2021.02.008
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发表时间：
2021-05-28
期刊：
影响因子：
3.6
通讯作者：
Furuse, Junji
中科院分区：
文献类型：
--
作者：
Imaoka, Hiroshi;Ikeda, Masafumi;Furuse, Junji
背景：胰腺未分化癌（UC）被认为是一种高度侵袭性的恶性肿瘤。然而，只有少数研究系统地描述了UC患者的临床过程。本研究的目的是阐明预后和构建一个预后模型，为患者不可切除的UC。方法：本研究在日本的17个机构进行，共55例患者进行了分析。结果：中位总生存期（OS）的患者不可切除的UC为3.95个月。在多变量考克斯比例风险（CPH）模型中，年龄>65岁、东部肿瘤协作组体力状态（ECOG PS）>2、C反应蛋白（CRP）>10 mg/L是OS的独立预后因素（年龄>65岁：风险比[HR]，2.732; 95%置信区间[CI]，1.353-5.515; ECOG PS > 2：HR，7.866; 95% CI，1.981-31.241; CRP >10 mg/L：HR，1.956; 95%CI，1.013-3.775）。根据CPH模型的B系数，预后评分定义如下：年龄>65岁（3分），ECOG PS > 2（6分），CRP >10 ml/L（2分）。最终的预测模型是这些点的总和。导出的预后模型将患者分为高风险（评分>4）和低风险（评分0 - 3）组，OS有显著差异（分别为1.45和8.19个月; p < 0.001）。这些研究结果表明，该模型可以作为患者信息和决策的工具，关于UC的治疗策略。(c)2021年IAP和EPC。Elsevier B. V.出版，保留所有权利。
Background: Undifferentiated carcinoma (UC) of the pancreas has been considered a highly aggressive malignancy. However, only a few studies have systematically described the clinical course of UC patients. The aim of this study was to clarify the prognosis and construct a prognostic model for patients with unresectable UC.Methods: This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.Results: The median overall survival (OS) of patients with unresectable UC was 3.95 months. In the multivariate Cox proportional hazards (CPH) model, age >65 years, Eastern Cooperative Oncology Group performance status (ECOG PS) >2, and C-reactive protein (CRP) >10 mg/L were independent prognostic factors for OS (age >65 years: hazard ratio [HR], 2.732; 95% confidence interval [CI], 1.353-5.515; ECOG PS > 2: HR, 7.866; 95% CI, 1.981-31.241; CRP >10 mg/L: HR, 1.956; 95% CI, 1.013-3.775). Based on the b coefficients from the CPH model, the prognostic scores were defined as follows: age >65 years (3 points), ECOG PS > 2 (6 points), and CRP >10 ml/L (2 points). The final prognostic model was the sum of the points. The derived prognostic model stratified patients into high-risk (score >4) and low-risk (score 0 -3) groups, with significant differences in OS (1.45 vs. 8.19 months, respectively; p < 0.001).Conclusions: The prognostic model stratified patients into high-risk and low-risk groups. These findings suggest that this model can serve as a tool for patient information and decision-making with regard to the therapeutic strategy for UC.(c) 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.