Simple Clinical, Laboratory Parameters Predict Mortality in Pancreatic Adenocarcinoma

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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.

New, less aggressive guidelines have been developed for management of pancreatic cysts.
The Khorana score and other factors of early mortality help identify high-risk patients after surgical resection for pancreatic cancer.
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
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