Department of General Surgery, University of Rome La Sapienza, Rome, Italy.
Ann Surg Oncol. 2012 Sep;19(9):2917-23. doi: 10.1245/s10434-012-2348-9. Epub 2012 Apr 10.
Survival rates after resection of pancreatic adenocarcinoma are poor; however, several tumor-related prognostic factors have been identified. There is increasing evidence that additional patient-related prognostic factors, such as ongoing systemic inflammatory response, are associated with poor outcomes in patients with common solid tumors. The purpose of this study was to evaluate the prognostic significance of the modified glasgow prognostic score (mGPS) in resected pancreatic ductal adenocarcinoma.
Data were collected from 101 patients who had undergone pancreatic resection for ductal adenocarcinoma. Tumor and host factors were analyzed by Kaplan-Meier and Cox proportional hazard models to evaluate their potential prognostic effects.
An elevated mGPS was associated with lower overall survival rate after pancreatic resection. The median actuarial survival rate for patients with an mGPS of 0, 1, or 2 was 37.2, 11.5, and 7.3, respectively (p = 0.0001). The Cox proportional hazards model, including all the parameters statistically significant at univariate analysis, demonstrated that mGPS, lymph node ratio (LNR), and positive resection margins were independent negative prognostic factors
Margin involvement, LNR, and the preoperative mGPS were identified as independent predictors of survival in patients undergoing potentially curative pancreatic resection. Based on the present results and existing validation literature, the mGPS should be included in the routine assessment of patients with pancreatic cancer to better stratify patients for entry into therapeutic trials.
胰腺腺癌切除术后的存活率较低；然而，已经确定了几个与肿瘤相关的预后因素。越来越多的证据表明，与常见实体瘤患者不良结局相关的其他与患者相关的预后因素，如持续的全身炎症反应。本研究旨在评估改良格拉斯哥预后评分（mGPS）在切除的胰腺导管腺癌中的预后意义。
从 101 名接受胰腺导管腺癌切除术的患者中收集数据。通过 Kaplan-Meier 和 Cox 比例风险模型分析肿瘤和宿主因素，以评估其潜在的预后影响。
升高的 mGPS 与胰腺切除后总体生存率降低相关。mGPS 为 0、1 或 2 的患者的中位生存时间分别为 37.2、11.5 和 7.3 个月（p = 0.0001）。包括单因素分析中所有统计学显著参数的 Cox 比例风险模型表明，mGPS、淋巴结比率（LNR）和阳性切缘是独立的负预后因素。
切缘受累、LNR 和术前 mGPS 被确定为接受潜在可治愈性胰腺切除术的患者生存的独立预测因素。基于目前的结果和现有验证文献，mGPS 应纳入胰腺癌患者的常规评估中，以更好地对患者进行分层，以便进入治疗试验。
