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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2020

Open Access 01-06-2020 | Pancreatic Tumors

The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection

Authors: Elisabeth S. Gruber, MD, Gerd Jomrich, MD, Alexandra Kaider, MSc, Michael Gnant, MD, Klaus Sahora, MD, Martin Schindl, MD

Published in: Annals of Surgical Oncology | Issue 6/2020

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Abstract

Background

Cancer-related inflammation is associated with tumour proliferation, maintenance and dissemination. It therefore impacts pancreatic cancer survival. The goal of this study was to examine the Prognostic Index (PI) as a prognostic biomarker for survival in patients with pancreatic ductal adenocarcinoma (PDAC). In addition, we explored factors known to interact with the immune and inflammation cascade that might interfere with the PI’s strength for prognostication.

Methods

Patients with PDAC undergoing resection were analysed retrospectively. The PI was calculated from preoperatively derived C-reactive protein levels and white blood count. Data were subject to correlation and survival analysis.

Results

Of 357 patients, 235 (65.8%) patients had a PI 0, 108 (30.3%) PI 1, and 14 (3.9%) PI 2. Median (quartiles) survival with a high PI (group 1 + 2) was 13.2 months (7.7–27.0), compared with 18.7 months (10.2–35.4) with a low PI (group 0; p = 0.012). The PI proved to be an independent prognostic factor for cancer-specific survival (p = 0.003) adjusted for conventional prognostic factors. Prognostic strength was influenced by the presence of a bile stent (p = 0.032).

Conclusions

The PI is a strong and solid independent prognostic tool for survival in patients with PDAC undergoing resection. Preoperative survey of inflammatory activity as provided by the use of a biomarker like the PI may help to identify those patients at risk of a poor prognosis.
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Metadata
Title
The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection
Authors
Elisabeth S. Gruber, MD
Gerd Jomrich, MD
Alexandra Kaider, MSc
Michael Gnant, MD
Klaus Sahora, MD
Martin Schindl, MD
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-08161-6

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