Performance status of patients is the major prognostic factor at all stages of pancreatic cancer

The aim of this study was to identify and evaluate the clinicopathologic factors and to elucidate the clinical importance of performance status on the outcome of patients with pancreatic cancer. The data of 335 patients with histologically confirmed diagnosis of pancreatic cancer who were treated and followed up between 2000 and 2010 were recorded from medical charts. The median age of the patients was 59 years (range 25-88 years) and 226 (67.5 %) were male. The study group comprised localized disease (18 %), locally advanced disease (36 %) and metastatic disease (46 %). The median survival of all patients was 280 days and the 4-year survival rate was 5 %. Univariate analysis indicated that initial poor performance status of patients (PS 2-4) was significantly associated with shorter survival in localized (p = 0.015), locally advanced (p = 0.01), metastatic stage (p < 0.001) and in the whole group (p < 0.001). Multivariate analyses also showed the same findings except in local disease (p = 0.04 for locally advanced disease, p = 0.002 for metastatic stage, and p < 0.001 for all stages). In patients with poor performance status, severe weight loss (> 10 %) (p = 0.007), large tumor diameter (> 3 cm) (p = 0.046), and especially metastatic disease (p < 0.001) were associated with significantly shorter overall survival. The performance status of a patient is the major prognostic factor predicting overall survival for all stages of pancreatic cancer. Severe weight loss, large tumor, and metastatic disease were found to be unfavorable prognostic factors in patients with poor performance status.