A preoperative score to predict early death after pancreatic cancer resection

G Balzano, E Dugnani, S Crippa, M Scavini, Valentina Pasquale, F Aleotti, Daniela Liberati, A Gandolfi, G Belfiori, M Reni, C Doglioni, Giacomo Ruffo, C Marmorale, M Falconi, L Piemonti

Research output: Contribution to journalArticle

Abstract

Background This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC. Results Seventy-eight out of 296 patients (26%) died within the first year. Preoperative independent predictors of one year mortality were: nutritional status (Geriatric Nutritional Risk Index, OR 2.23, 1.14–4.38; p = 0.02), American Society of Anaesthesiologists’ score (OR 2.56, 1.1–5.98; p = 0.03), abdominal or back pain at presentation (OR 2.51, 1.05–5.9; p = 0.038) and non metastatic liver disease as comorbidity (OR 4.5, 1.05–19.3; p = 0.043). A score ranging from 0 to 7 points was developed. In the validation cohort, the model was able to predict early mortality (OR 7.1, 3.9–12.7; p < 0.0001), with a predictive ability of 53.5% (Nagelkerke R 2 ), an area under the receiver operating characteristic curve of 88.7% and an acceptable calibration (goodness-of-fit test, p = 0.403). Conclusions Our new simple risk score proved reliable in forecasting one year mortality in patients with resectable PDAC. © 2017 Editrice Gastroenterologica Italiana S.r.l.
Original languageEnglish
Pages (from-to)1050-1056
Number of pages7
JournalDigestive and Liver Disease
Volume49
Issue number9
DOIs
Publication statusPublished - 2017

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Pancreatic Neoplasms
Adenocarcinoma
Mortality
Nutrition Assessment
Back Pain
Nutritional Status
ROC Curve
Geriatrics
Abdominal Pain
Calibration
Observational Studies
Comorbidity
Liver Diseases
Cohort Studies

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A preoperative score to predict early death after pancreatic cancer resection. / Balzano, G; Dugnani, E; Crippa, S; Scavini, M; Pasquale, Valentina; Aleotti, F; Liberati, Daniela; Gandolfi, A; Belfiori, G; Reni, M; Doglioni, C; Ruffo, Giacomo; Marmorale, C; Falconi, M; Piemonti, L.

In: Digestive and Liver Disease, Vol. 49, No. 9, 2017, p. 1050-1056.

Research output: Contribution to journalArticle

Balzano, G ; Dugnani, E ; Crippa, S ; Scavini, M ; Pasquale, Valentina ; Aleotti, F ; Liberati, Daniela ; Gandolfi, A ; Belfiori, G ; Reni, M ; Doglioni, C ; Ruffo, Giacomo ; Marmorale, C ; Falconi, M ; Piemonti, L. / A preoperative score to predict early death after pancreatic cancer resection. In: Digestive and Liver Disease. 2017 ; Vol. 49, No. 9. pp. 1050-1056.
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abstract = "Background This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC. Results Seventy-eight out of 296 patients (26{\%}) died within the first year. Preoperative independent predictors of one year mortality were: nutritional status (Geriatric Nutritional Risk Index, OR 2.23, 1.14–4.38; p = 0.02), American Society of Anaesthesiologists’ score (OR 2.56, 1.1–5.98; p = 0.03), abdominal or back pain at presentation (OR 2.51, 1.05–5.9; p = 0.038) and non metastatic liver disease as comorbidity (OR 4.5, 1.05–19.3; p = 0.043). A score ranging from 0 to 7 points was developed. In the validation cohort, the model was able to predict early mortality (OR 7.1, 3.9–12.7; p < 0.0001), with a predictive ability of 53.5{\%} (Nagelkerke R 2 ), an area under the receiver operating characteristic curve of 88.7{\%} and an acceptable calibration (goodness-of-fit test, p = 0.403). Conclusions Our new simple risk score proved reliable in forecasting one year mortality in patients with resectable PDAC. {\circledC} 2017 Editrice Gastroenterologica Italiana S.r.l.",
author = "G Balzano and E Dugnani and S Crippa and M Scavini and Valentina Pasquale and F Aleotti and Daniela Liberati and A Gandolfi and G Belfiori and M Reni and C Doglioni and Giacomo Ruffo and C Marmorale and M Falconi and L Piemonti",
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T1 - A preoperative score to predict early death after pancreatic cancer resection

AU - Balzano, G

AU - Dugnani, E

AU - Crippa, S

AU - Scavini, M

AU - Pasquale, Valentina

AU - Aleotti, F

AU - Liberati, Daniela

AU - Gandolfi, A

AU - Belfiori, G

AU - Reni, M

AU - Doglioni, C

AU - Ruffo, Giacomo

AU - Marmorale, C

AU - Falconi, M

AU - Piemonti, L

PY - 2017

Y1 - 2017

N2 - Background This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC. Results Seventy-eight out of 296 patients (26%) died within the first year. Preoperative independent predictors of one year mortality were: nutritional status (Geriatric Nutritional Risk Index, OR 2.23, 1.14–4.38; p = 0.02), American Society of Anaesthesiologists’ score (OR 2.56, 1.1–5.98; p = 0.03), abdominal or back pain at presentation (OR 2.51, 1.05–5.9; p = 0.038) and non metastatic liver disease as comorbidity (OR 4.5, 1.05–19.3; p = 0.043). A score ranging from 0 to 7 points was developed. In the validation cohort, the model was able to predict early mortality (OR 7.1, 3.9–12.7; p < 0.0001), with a predictive ability of 53.5% (Nagelkerke R 2 ), an area under the receiver operating characteristic curve of 88.7% and an acceptable calibration (goodness-of-fit test, p = 0.403). Conclusions Our new simple risk score proved reliable in forecasting one year mortality in patients with resectable PDAC. © 2017 Editrice Gastroenterologica Italiana S.r.l.

AB - Background This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC. Results Seventy-eight out of 296 patients (26%) died within the first year. Preoperative independent predictors of one year mortality were: nutritional status (Geriatric Nutritional Risk Index, OR 2.23, 1.14–4.38; p = 0.02), American Society of Anaesthesiologists’ score (OR 2.56, 1.1–5.98; p = 0.03), abdominal or back pain at presentation (OR 2.51, 1.05–5.9; p = 0.038) and non metastatic liver disease as comorbidity (OR 4.5, 1.05–19.3; p = 0.043). A score ranging from 0 to 7 points was developed. In the validation cohort, the model was able to predict early mortality (OR 7.1, 3.9–12.7; p < 0.0001), with a predictive ability of 53.5% (Nagelkerke R 2 ), an area under the receiver operating characteristic curve of 88.7% and an acceptable calibration (goodness-of-fit test, p = 0.403). Conclusions Our new simple risk score proved reliable in forecasting one year mortality in patients with resectable PDAC. © 2017 Editrice Gastroenterologica Italiana S.r.l.

U2 - 10.1016/j.dld.2017.06.012

DO - 10.1016/j.dld.2017.06.012

M3 - Article

VL - 49

SP - 1050

EP - 1056

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 9

ER -