Abstract Journal for Surgical Oncology

Abstract

To develop a prognostic score to predict mortality in patients who had pancreaticoduodenectomies (PDD) for pancreatic cancer. Methods: Evaluation of a prospectively collected database of 160 consecutive patients undergoing PDD was undertaken. Factors considered included patient factors, tumour biology, surgical technique (vascular resection), blood loss and post-operative complications (graded based on Clavien-Dindo classifi cation). Hazard regression and Kaplan-Meier survival curve analysis was performed. A mortality predictive score was developed using identifi ed predictors (ASA, vascular resection, tumour grade, margins, perineural involvement and nodal involvement). Each predictor was assigned integer values based on proportionate hazard ratios. Low risk was arbitrarily classifi ed as a score of 0-5, moderate risk from 6-10 and high risk > 11. Results: Mean patient age was 66.6 years. Vascular resection was performed in 53.1% of cases. Median survival (Kaplan-Meier) was 25.7 3.6 months. ASA score > 2 (HR 1.7, p = 0.016), marginal involvement (HR 1.8, p = 0.016), perineural invasion (HR 2.0, p = 0.005), tumour grade (HR 2.0, p 2 nodes positive) demonstrated an inverse relationship with survival (p < 0.001). The mortality index reliably predicted mortality at all time points (Breslow, Tarone-Ware, log-rank p < 0.001).

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