The Khorana score and other associated factors of early mortality help identify high-risk patients after surgical resection for pancreatic cancer, according to an article published online in Cancer.
The cohort study examined 334 patients with a median age of 67 years who underwent surgical resection for pancreatic cancer between January 2006 and June 2013. Of the enrolled patients, 50% were female and 86% were white.
The primary tumor site was the pancreatic head for 73% of patients. Of the tumors, 67% were T3 and 63% were N1.
High-risk patients were defined as having a Khorana score greater than three. Out of the 334 patients, 152 (47%) were considered to be high risk. The median Khorana score was determined to be two.
The two major adjunctive treatments for patients included chemotherapy and radiotherapy (70% and 40%, respectively).
There was an observed difference of the postoperative 30 day mortality rate and the 6-month mortality rate between patients who were not determined to be high risk and those who were.
For those patients who weren’t high-risk, the 30-day mortality rate was 0.9% and the 6-month mortality rate was 9.4%.
High-risk patients experienced significantly higher mortality rates, with 13.4% having 30-day and 5.6% experiencing 6-month mortality (P=0.02).
The study suggests that future research focus on preoperative interventions for patients who are considered high-risk for early mortality.
Sohal, D. P.S., Shrotriya, S., Glass, K. T., Pelley, R. J., McNamara, M. J., Estfan, B., Shapiro, M., Wey, J., Chalikonda, S., Morris-Stiff, G., Walsh, R. M. and Khorana, A. A. (2015), Predicting early mortality in resectable pancreatic adenocarcinoma: A cohort study. Cancer, 121: 1779-1784. doi: 10.1002/cncr.29298