Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas
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 unre...
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| Veröffentlicht in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2021-06, Vol.21 (4), p.738-745 |
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| creator | Imaoka, Hiroshi Ikeda, Masafumi Maehara, Kosuke Umemoto, Kumiko Ozaka, Masato Kobayashi, Satoshi Terashima, Takeshi Inoue, Hiroto Sakaguchi, Chihiro Tsuji, Kunihiro Shioji, Kazuhiko Okamura, Keiya Tsujimoto, Akiko Nakamura, Ikuo Shirakawa, Hirofumi Furukawa, Masayuki Ueno, Makoto Morizane, Chigusa Furuse, Junji |
| description | 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.
This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.
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 β 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 |
| doi_str_mv | 10.1016/j.pan.2021.02.008 |
| format | Article |
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This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.
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 β 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).
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.</description><identifier>ISSN: 1424-3903</identifier><identifier>EISSN: 1424-3911</identifier><identifier>DOI: 10.1016/j.pan.2021.02.008</identifier><identifier>PMID: 33602645</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Age ; Aged ; Anaplastic carcinoma ; Antigens ; C-reactive protein ; Carcinoma ; Chemotherapy ; Decision making ; Humans ; Laboratories ; Malignancy ; Medical prognosis ; Metastasis ; Osteoclast-like giant cells ; Pancreas ; Pancreatic carcinoma ; Patients ; Prognosis ; Prognostic factor ; Prognostic model ; Retrospective Studies ; Risk Assessment ; Risk groups ; Tumors ; Undifferentiated carcinoma</subject><ispartof>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2021-06, Vol.21 (4), p.738-745</ispartof><rights>2021 IAP and EPC</rights><rights>Copyright © 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.</rights><rights>2021. IAP and EPC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-996129b0ec1c1b245a5d3d15ca59f0aaacaa39df046c31455454f00a5da098ce3</citedby><cites>FETCH-LOGICAL-c381t-996129b0ec1c1b245a5d3d15ca59f0aaacaa39df046c31455454f00a5da098ce3</cites><orcidid>0000-0003-0584-0095 ; 0000-0002-2535-6586 ; 0000-0003-2101-0163 ; 0000-0002-4050-2086</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33602645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Imaoka, Hiroshi</creatorcontrib><creatorcontrib>Ikeda, Masafumi</creatorcontrib><creatorcontrib>Maehara, Kosuke</creatorcontrib><creatorcontrib>Umemoto, Kumiko</creatorcontrib><creatorcontrib>Ozaka, Masato</creatorcontrib><creatorcontrib>Kobayashi, Satoshi</creatorcontrib><creatorcontrib>Terashima, Takeshi</creatorcontrib><creatorcontrib>Inoue, Hiroto</creatorcontrib><creatorcontrib>Sakaguchi, Chihiro</creatorcontrib><creatorcontrib>Tsuji, Kunihiro</creatorcontrib><creatorcontrib>Shioji, Kazuhiko</creatorcontrib><creatorcontrib>Okamura, Keiya</creatorcontrib><creatorcontrib>Tsujimoto, Akiko</creatorcontrib><creatorcontrib>Nakamura, Ikuo</creatorcontrib><creatorcontrib>Shirakawa, Hirofumi</creatorcontrib><creatorcontrib>Furukawa, Masayuki</creatorcontrib><creatorcontrib>Ueno, Makoto</creatorcontrib><creatorcontrib>Morizane, Chigusa</creatorcontrib><creatorcontrib>Furuse, Junji</creatorcontrib><title>Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas</title><title>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</title><addtitle>Pancreatology</addtitle><description>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.
This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.
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 β 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).
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.</description><subject>Age</subject><subject>Aged</subject><subject>Anaplastic carcinoma</subject><subject>Antigens</subject><subject>C-reactive protein</subject><subject>Carcinoma</subject><subject>Chemotherapy</subject><subject>Decision making</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Malignancy</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Osteoclast-like giant cells</subject><subject>Pancreas</subject><subject>Pancreatic carcinoma</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Prognostic factor</subject><subject>Prognostic model</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk groups</subject><subject>Tumors</subject><subject>Undifferentiated carcinoma</subject><issn>1424-3903</issn><issn>1424-3911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo7jr6AbxIwIuXaauSdO8ET7L4DxYE0XOoSVfcjDPJmKRX_PZmmXUPHrykEvKrR9V7QjxHGBBwer0bjpQGBQoHUAPA5oE4R6PMWlvEh_d30GfiSa07AKUQ7WNxpvUEajLjuahfYv0hayvUYoi-nzlJSrM8lvw95dqil4F8y6XKmOSxA5xalb9iu5ZLKlzZN9ruuT_mGAKX_h2p8Sw9FR9TPpDMQbZr7s3JF6b6VDwKtK_87K6uxLf3775eflxfff7w6fLt1drrDba1tRMquwX26HGrzEjjrGccPY02ABF5Im3nAGbyGs04mtEEgE4R2I1nvRKvTrp9l58L1-YOsXre7ylxXqpTxqI1gOaioy__QXd5KalP59SotboA6GUl8ET5kmstHNyxxAOV3w7B3Sbidq4v6W4TcaBcT6T3vLhTXrYHnu87_kbQgTcngLsVN5GLq7577HmOpXvr5hz_I_8H_DqdgA</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Imaoka, Hiroshi</creator><creator>Ikeda, Masafumi</creator><creator>Maehara, Kosuke</creator><creator>Umemoto, Kumiko</creator><creator>Ozaka, Masato</creator><creator>Kobayashi, Satoshi</creator><creator>Terashima, Takeshi</creator><creator>Inoue, Hiroto</creator><creator>Sakaguchi, Chihiro</creator><creator>Tsuji, Kunihiro</creator><creator>Shioji, Kazuhiko</creator><creator>Okamura, Keiya</creator><creator>Tsujimoto, Akiko</creator><creator>Nakamura, Ikuo</creator><creator>Shirakawa, Hirofumi</creator><creator>Furukawa, Masayuki</creator><creator>Ueno, Makoto</creator><creator>Morizane, Chigusa</creator><creator>Furuse, Junji</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0584-0095</orcidid><orcidid>https://orcid.org/0000-0002-2535-6586</orcidid><orcidid>https://orcid.org/0000-0003-2101-0163</orcidid><orcidid>https://orcid.org/0000-0002-4050-2086</orcidid></search><sort><creationdate>202106</creationdate><title>Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas</title><author>Imaoka, Hiroshi ; 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[et al.]</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Imaoka, Hiroshi</au><au>Ikeda, Masafumi</au><au>Maehara, Kosuke</au><au>Umemoto, Kumiko</au><au>Ozaka, Masato</au><au>Kobayashi, Satoshi</au><au>Terashima, Takeshi</au><au>Inoue, Hiroto</au><au>Sakaguchi, Chihiro</au><au>Tsuji, Kunihiro</au><au>Shioji, Kazuhiko</au><au>Okamura, Keiya</au><au>Tsujimoto, Akiko</au><au>Nakamura, Ikuo</au><au>Shirakawa, Hirofumi</au><au>Furukawa, Masayuki</au><au>Ueno, Makoto</au><au>Morizane, Chigusa</au><au>Furuse, Junji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas</atitle><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle><addtitle>Pancreatology</addtitle><date>2021-06</date><risdate>2021</risdate><volume>21</volume><issue>4</issue><spage>738</spage><epage>745</epage><pages>738-745</pages><issn>1424-3903</issn><eissn>1424-3911</eissn><abstract>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.
This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.
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 β 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).
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.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>33602645</pmid><doi>10.1016/j.pan.2021.02.008</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0584-0095</orcidid><orcidid>https://orcid.org/0000-0002-2535-6586</orcidid><orcidid>https://orcid.org/0000-0003-2101-0163</orcidid><orcidid>https://orcid.org/0000-0002-4050-2086</orcidid></addata></record> |
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| ispartof | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2021-06, Vol.21 (4), p.738-745 |
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| subjects | Age Aged Anaplastic carcinoma Antigens C-reactive protein Carcinoma Chemotherapy Decision making Humans Laboratories Malignancy Medical prognosis Metastasis Osteoclast-like giant cells Pancreas Pancreatic carcinoma Patients Prognosis Prognostic factor Prognostic model Retrospective Studies Risk Assessment Risk groups Tumors Undifferentiated carcinoma |
| title | Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas |
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