Risk stratification and prognostic factors in patients with unresectable undifferentiated carcinoma of the pancreas

Background: Undifferentiated carcinoma (UC) of the pancreas has been considered a highly aggressive malignancy. However, only a few studies have systematically described the clinical course of UC patients. The aim of this study was to clarify the prognosis and construct a prognostic model for patients with unresectable UC. Methods: This study was conducted at 17 institutions in Japan, and a total of 55 patients were analyzed. Results: The median overall survival (OS) of patients with unresectable UC was 3.95 months. In the multivariate Cox proportional hazards (CPH) model, age >65 years, Eastern Cooperative Oncology Group performance status (ECOG PS) >2, and C-reactive protein (CRP) >10 mg/L were independent prognostic factors for OS (age >65 years: hazard ratio [HR], 2.732; 95% confidence interval [CI], 1.353-5.515; ECOG PS > 2: HR, 7.866; 95% CI, 1.981-31.241; CRP >10 mg/L: HR, 1.956; 95% CI, 1.013-3.775). Based on the b coefficients from the CPH model, the prognostic scores were defined as follows: age >65 years (3 points), ECOG PS > 2 (6 points), and CRP >10 ml/L (2 points). The final prognostic model was the sum of the points. The derived prognostic model stratified patients into high-risk (score >4) and low-risk (score 0 -3) groups, with significant differences in OS (1.45 vs. 8.19 months, respectively; p < 0.001). Conclusions: The prognostic model stratified patients into high-risk and low-risk groups. These findings suggest that this model can serve as a tool for patient information and decision-making with regard to the therapeutic strategy for UC. (c) 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to clarify the prognosis of patients with unresectable undifferentiated carcinoma (UC) of the pancreas and construct a prognostic model. Independent prognostic factors were identified through multivariate analysis and used to define a prognostic model that stratified patients into high-risk and low-risk groups with significant differences in overall survival.