Development of a Prognostic Model That Predicts Survival After Pancreaticoduodenectomy for Ampullary Cancer
| Autor: | Michael, Feretis, Tengyao, Wang, Satheesh, Iype, Adam, Duckworth, Rebecca, Brais, Bristi, Basu, Neville V, Jamieson, Emmanuel, Huguet, Anita, Balakrishnan, Asif, Jah, Raaj K, Praseedom, Simon J, Harper, Siong-Seng, Liau |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Aged 80 and over Male Ampulla of Vater periampullary tumors ampullary adenocarcinoma Common Bile Duct Neoplasms Pilot Projects Kaplan-Meier Estimate Original Articles Middle Aged Prognosis survival Pancreaticoduodenectomy Pancreatic Neoplasms Lymphatic Metastasis Multivariate Analysis Humans Female Aged Proportional Hazards Models Retrospective Studies |
| Zdroj: | Pancreas |
| ISSN: | 1536-4828 |
| Popis: | Objectives The aims of this study were to (i) identify independent predictors of survival after pancreaticoduodenectomy for ampullary cancer and (ii) develop a prognostic model of survival. Methods Data were analyzed retrospectively on 110 consecutive patients who underwent pancreaticoduodenectomy between 2002 and 2013. Subjects were categorized into 3 nodal subgroups as per the recently proposed nodal subclassification: N0 (node negative), N1 (1–2 metastatic nodes), or N2 (≥3 metastatic nodes). Clinicopathological features and overall survival were compared by Kaplan-Meier and Cox regression analyses. Results The overall 1-, 3-, and 5-year survival rates were 79.8%, 42.2%, and 34.9%, respectively. The overall 1-, 3-, and 5-year survival rates for the N0 group were 85.2%, 71.9%, and 67.4%, respectively. The 1-, 3-, 5-year survival rates for the N1 and N2 subgroups were 81.5%, 49.4%, and 49.4% and 75%, 19.2%, and 6.4%, respectively (log rank, P < 0.0001). After performing a multivariate Cox regression analysis, vascular invasion and lymph node ratio were the only independent predictors of survival. Hence, a prediction model of survival was constructed based on those 2 variables. Conclusions Using data from a carefully selected cohort of patients, we created a pilot prognostic model of postresectional survival. The proposed model may help clinicians to guide treatments in the adjuvant setting. |
| Databáze: | OpenAIRE |
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