Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
In Vivo. 2021 Jan-Feb;35(1):507-515. doi: 10.21873/invivo.12285.
BACKGROUND/AIM: Survival of patients with pancreatic cancer remains poor despite improvements in therapeutic strategies. This study aims to create a novel preoperative score to predict prognosis in patients with tumors of the pancreaticobiliary head.
Data on 190 patients who underwent to pancreaticoduodenectomy at Sapienza University of Rome from January 2010 to December 2018 were retrospectively analyzed. After exclusion criteria, 101 patients were considered eligible for retrospective study. Preoperative biological, clinical and radiological parameters were considered.
Pancreatic ductal adenocarcinoma [hazard ratio (HR)=1.995, 95% confidence intervaI (CI)=1.1-3.3; p=0.01], carbohydrate antigen 19.9 (CA 19.9) >230 U/ml (HR=2.414, 95% CI=2.4-1.5, p<0.0001) and Wirsung duct diameter >3 mm (HR=1.592, 95% CI=1.5-0.9; p=0.08) were the only parameters associated with poor prognosis. Through these parameters, a prognostic score (PHT score) was developed which predicted worst survival when exceeding 2 and better survival when ≤2.
The PHT score may have a potential impact on predicting overall survival and consequently modulate the timing and type of treatment (up-front surgery vs. neoadjuvant therapy) patients are offered.
背景/目的：尽管治疗策略有所改进，胰腺癌患者的生存率仍然很差。本研究旨在创建一种新的术前评分，以预测胰头胆管肿瘤患者的预后。
回顾性分析了 2010 年 1 月至 2018 年 12 月在罗马 Sapienza 大学接受胰十二指肠切除术的 190 名患者的数据。排除标准后，101 名患者被认为适合回顾性研究。考虑了术前生物学、临床和影像学参数。
胰腺导管腺癌（危险比 [HR]=1.995，95%置信区间 [CI]=1.1-3.3；p=0.01）、CA19.9>230 U/ml（HR=2.414，95% CI=2.4-1.5，p<0.0001）和 Wirsung 胆管直径>3mm（HR=1.592，95% CI=1.5-0.9；p=0.08）是与不良预后相关的唯一参数。通过这些参数，开发了一种预后评分（PHT 评分），当评分超过 2 分时预测最差生存，评分≤2 时预测更好的生存。
PHT 评分可能对预测总生存有潜在影响，并因此调节患者接受的治疗（ upfront surgery vs. neoadjuvant therapy）的时机和类型。
