Impact of modified physiobiological parameter-based grading system on long-term prognosis for resectable pancreatic cancer following curative surgery

Abstract

Introduction: Several cancer inflammation based predicting prognostic score are developed. The optimal prognostic predicting score for early pancreatic ductal adenocarcinoma (PDAC) still remains to be unclear. Method: One-hundred sixty-four consecutive patients with resectable PDAC were enrolled between November 2004 and March 2017. Univariate and multivariate analyses identified variables associated with overall survival (OS) and recurrence-free survival (RFS). Patients were stratified according to the physiobiological parameter-based grading system (PGS), with a PGS cut-off value of 40.5 being estimated by receiver operating characteristic curve. Result: Compared to patients with non-sarcopenia, those with sarcopenia had worse OS and RFS (P = 0.046, P = 0.036, respectively). Patients with high-PGS had worse OS and RFS, rather than patients with low-PGS (P < 0.001, P < 0.001, respectively). Combined evaluation of sarcopenia and PGS had significantly predicted long-term prognosis after curative intent surgery for PDAC. Especially, this modified prognostic score was efficacious in patients with early stage of PDAC. Conclusion: This study shows how the combination of PGS and sarcopenia effectively stratifies outcomes in patients with early stage PDAC undergoing curative surgery. These data support routine staging of both the tumor and the host in patients with PDAC.