RUE MERMOZ BESANCON PC
At the time of diagnosis, up to 35% of patients with PC present with locally advanced disease ( Philip, 2011). Most PCs are unresectable due to the presence of either distant metastases or locoregional metastases, including vascular invasion (locally advanced PC: LAPC). By analogy, a similar prediction has been reported for women with breast cancer ( N=89 300) ( Malvezzi et al, 2014). Number of deaths by PC in 2014 in the European Union (EU) has been estimated to 82 300 cases equally distributed in men and women. This unfavourable trend emphasises the importance of giving priority to research in PC prevention and treatment. The predicted death rates have progressively increased over the past years ( Siegel et al, 2016). Pancreatic cancer (PC) is one of the leading causes of cancer-related mortality worldwide, with 5-year relative survival of only 8%. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future. The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. The score ability to discriminate OS was externally confirmed in 63 (59%) patients with complete clinical data derived from a data set of 106 consecutive LAPC patients median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank P<0.0001). The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank P<0.0001). The final model had good calibration, acceptable discrimination (C-index=0.60) and robust internal validity. Results:Īge, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besançon Hospital, France. Performance assessment and internal validation of the final model were done with Harrell’s C-index, calibration plot and bootstrap sample procedures. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. Methods:Īnalyses were derived from 442 LAPC patients enrolled in the LAP07 trial. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP). Better discrimination for overall survival (OS) at diagnosis is needed. The management of locally advanced pancreatic cancer (LAPC) patients remains controversial.
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