Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas.
Anaplastic carcinoma
Osteoclast-like giant cells
Prognostic factor
Prognostic model
Undifferentiated carcinoma
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
09
12
2020
revised:
22
01
2021
accepted:
10
02
2021
pubmed:
20
2
2021
medline:
24
12
2021
entrez:
19
2
2021
Statut:
ppublish
Résumé
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.
Sections du résumé
BACKGROUND
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
METHODS
This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed.
RESULTS
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 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).
CONCLUSIONS
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.
Identifiants
pubmed: 33602645
pii: S1424-3903(21)00058-2
doi: 10.1016/j.pan.2021.02.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
738-745Informations de copyright
Copyright © 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Hiroshi Imaoka has received research funding from Ono Pharmaceutical; honoraria from Yakult Honsha, AstraZeneca, and Nihon Servier; and is a member of advisory board for Nihon Servier. Masafumi Ikeda has received research funding from Yakult Honsha, Ono Pharmaceutical, Bristol-Myers Squibb, NanoCarrier, Novartis, Bayer, Eisai, Eli Lilly Japan, MSD, Chugai Pharma, AstraZeneca, J-Pharma, Pfizer, ASLAN Pharmaceuticals, Merck Serono, and Takeda; honoraria from Taiho Pharmaceutical, Yakult Honsha, Novartis, Bayer, Eisai, Eli Lilly Japan, Sumitomo Dainippon Pharma, Teijin Pharma, MSD, Mylan, Chugai Pharma, Astellas Pharma, EA Pharma, Gilead, Otsuka, and Nihon Servier; and is a member of advisory board for Nihon Servier, Novartis, Bayer, Eisai, Eli Lilly Japan, Chugai Pharma, AstraZeneca, Shire, ASLAN Pharmaceuticals, and NanoCarrier. Satoshi Kobayashi has received research funding from Taiho Pharmaceutical, and Yakult Honsha; honoraria from Taiho Pharmaceutical, Kyowa Hakko Kirin, Bayer, Teijin Pharma, and Eisai. Makoto Ueno has received research funding from Taiho Pharmaceutical, Yakult Honsha, AstraZeneca, Merck Serono, MSD, Daiichi Sankyo, Astellas Pharma, Eisai, Ono Pharmaceutical, Sumitomo Dainippon Pharma, Incyte, and ASLAN Pharmaceuticals; honoraria from Taiho Pharmaceutical, Yakult Honsha, AstraZeneca, Merck Serono, Nipro Corporation, MSD, and Daiichi Sankyo. Chikusa Morizane has received research funding from Ono Pharmaceutical, Yakult Honsha, Eisai, J-Pharma, AstraZeneca, Merck Serono, and Taiho Pharmaceutical; and honoraria from Yakult Honsha, Eisai, MSD, Teijin Pharma, Taiho Pharmaceutical, and Novartis; and is a member of advisory board for Yakult Honsha, MSD, J-Pharma, AstraZeneca, Teijin Pharma, Taiho Pharmaceutical, and Novartis. Junji Furuse has received research funding from Ono Pharmaceutical, MSD, Sumitomo Dainippon Pharma, J-Pharma, Yakult Honsha, AstraZeneca, Daiichi Sankyo, Eisai, Bayer, Pfizer, NanoCarrier, Kyowa Hakko Kirin, Taiho Pharmaceutical, Chugai Pharma, Sanofi, Takeda, Mochida Pharmaceutical, Astellas Pharma, and Eli Lilly Japan; and honoraria from Eisai, Bayer, Taiho Pharmaceutical, Ono Pharmaceutical, Novartis, Yakult Honsha, Teijin Pharma, Shionogi, EA Pharma, Eli Lilly Japan, Takeda, Chugai Pharma, Mochida Pharmaceutical, Nihon Servier, Sanofi, Fujifilm Toyama Chemical, Nobel pharma, Pfizer, Sawai Pharmaceutical, Daiichi Sankyo, Sumitomo Dainippon Pharma, Merck Serono, Nippon Kayaku, MSD, Shire, and Kyowa Hakko Kirin. The other authors have no conflict of interest.