A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio

Bobby V M Dasari; Keith J Roberts; James Hodson; Lewis Stevens; Andrew M Smith; Stefan G Hubscher; John Isaac; Paolo Muiesan; Robert P Sutcliffe; Ravi Marudanayagam; Darius F Mirza

doi:10.1016/j.hpb.2015.11.008

A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio

Bobby V M Dasari, Keith J Roberts, James Hodson, Lewis Stevens, Andrew M Smith, Stefan G Hubscher, John Isaac, Paolo Muiesan, Robert P Sutcliffe, Ravi Marudanayagam, Darius F Mirza

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

BACKGROUND: Site of tumour origin, lymph node metastases and lymph node ratio (LNR) are identified as important factors determining prognosis in patients undergoing pancreaticoduodenectomy (PD). This study hypothesised that a prognostic index to predict survival could be developed through statistical modelling based on these pathological variables.

METHODS: Patients who underwent PD between 2004 and 2013 were included. Univariable and multivariable (Cox regression) analyses were performed to identify predictors of survival, and a prognostic index was derived. The prognostic index was then validated using an external patient cohort.

RESULTS: A total of 567 patients who underwent PD were used as a derivation cohort. Tumour site (p < 0.001), tumour size (p = 0.002), T-stage (p < 0.001), vascular involvement (p = 0.002), number of positive nodes (p < 0.001) and LNR (p < 0.001) were significantly associated with survival in univariable analysis. LNR (p < 0.001), tumour site (p < 0.001), T-stage (p = 0.007) remained significant predictors of survival in multivariable analysis, and were combined to derive a prognostic index. The accuracy of the prognostic index was assessed both on the original cohort, and a validation set of 194 patients from another institutional prospective database. The AUROC scores for predicting the overall survival at 3 years were 0.77 in the derivation cohort and 0.74 in the validation cohort.

CONCLUSION: The Pancreaticoduodenectomy Prognostic Index is a validated clinico-pathological model based on tumour site, T-stage and LNR to predict long-term survival following PD.

Original language	English
Pages (from-to)	332-338
Journal	HPB : the official journal of the International Hepato Pancreato Biliary Association
Volume	18
Issue number	4
Early online date	24 Feb 2016
DOIs	https://doi.org/10.1016/j.hpb.2015.11.008
Publication status	Published - Apr 2016

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Dasari, B. V. M., Roberts, K. J., Hodson, J., Stevens, L., Smith, A. M., Hubscher, S. G., Isaac, J., Muiesan, P., Sutcliffe, R. P., Marudanayagam, R., & Mirza, D. F. (2016). A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio. HPB : the official journal of the International Hepato Pancreato Biliary Association, 18(4), 332-338. Advance online publication. https://doi.org/10.1016/j.hpb.2015.11.008

@article{6ddf0436a6ea45ffb403bb28830e6e01,

title = "A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio",

abstract = "BACKGROUND: Site of tumour origin, lymph node metastases and lymph node ratio (LNR) are identified as important factors determining prognosis in patients undergoing pancreaticoduodenectomy (PD). This study hypothesised that a prognostic index to predict survival could be developed through statistical modelling based on these pathological variables.METHODS: Patients who underwent PD between 2004 and 2013 were included. Univariable and multivariable (Cox regression) analyses were performed to identify predictors of survival, and a prognostic index was derived. The prognostic index was then validated using an external patient cohort.RESULTS: A total of 567 patients who underwent PD were used as a derivation cohort. Tumour site (p < 0.001), tumour size (p = 0.002), T-stage (p < 0.001), vascular involvement (p = 0.002), number of positive nodes (p < 0.001) and LNR (p < 0.001) were significantly associated with survival in univariable analysis. LNR (p < 0.001), tumour site (p < 0.001), T-stage (p = 0.007) remained significant predictors of survival in multivariable analysis, and were combined to derive a prognostic index. The accuracy of the prognostic index was assessed both on the original cohort, and a validation set of 194 patients from another institutional prospective database. The AUROC scores for predicting the overall survival at 3 years were 0.77 in the derivation cohort and 0.74 in the validation cohort.CONCLUSION: The Pancreaticoduodenectomy Prognostic Index is a validated clinico-pathological model based on tumour site, T-stage and LNR to predict long-term survival following PD.",

author = "Dasari, {Bobby V M} and Roberts, {Keith J} and James Hodson and Lewis Stevens and Smith, {Andrew M} and Hubscher, {Stefan G} and John Isaac and Paolo Muiesan and Sutcliffe, {Robert P} and Ravi Marudanayagam and Mirza, {Darius F}",

year = "2016",

month = apr,

doi = "10.1016/j.hpb.2015.11.008",

language = "English",

volume = "18",

pages = "332--338",

journal = "HPB : the official journal of the International Hepato Pancreato Biliary Association",

issn = "1365-182X",

publisher = "Wiley",

number = "4",

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Dasari, BVM, Roberts, KJ, Hodson, J, Stevens, L, Smith, AM, Hubscher, SG, Isaac, J, Muiesan, P, Sutcliffe, RP, Marudanayagam, R & Mirza, DF 2016, 'A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio', HPB : the official journal of the International Hepato Pancreato Biliary Association, vol. 18, no. 4, pp. 332-338. https://doi.org/10.1016/j.hpb.2015.11.008

A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio. / Dasari, Bobby V M; Roberts, Keith J; Hodson, James et al.
In: HPB : the official journal of the International Hepato Pancreato Biliary Association, Vol. 18, No. 4, 04.2016, p. 332-338.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio

AU - Dasari, Bobby V M

AU - Roberts, Keith J

AU - Hodson, James

AU - Stevens, Lewis

AU - Smith, Andrew M

AU - Hubscher, Stefan G

AU - Isaac, John

AU - Muiesan, Paolo

AU - Sutcliffe, Robert P

AU - Marudanayagam, Ravi

AU - Mirza, Darius F

PY - 2016/4

Y1 - 2016/4

N2 - BACKGROUND: Site of tumour origin, lymph node metastases and lymph node ratio (LNR) are identified as important factors determining prognosis in patients undergoing pancreaticoduodenectomy (PD). This study hypothesised that a prognostic index to predict survival could be developed through statistical modelling based on these pathological variables.METHODS: Patients who underwent PD between 2004 and 2013 were included. Univariable and multivariable (Cox regression) analyses were performed to identify predictors of survival, and a prognostic index was derived. The prognostic index was then validated using an external patient cohort.RESULTS: A total of 567 patients who underwent PD were used as a derivation cohort. Tumour site (p < 0.001), tumour size (p = 0.002), T-stage (p < 0.001), vascular involvement (p = 0.002), number of positive nodes (p < 0.001) and LNR (p < 0.001) were significantly associated with survival in univariable analysis. LNR (p < 0.001), tumour site (p < 0.001), T-stage (p = 0.007) remained significant predictors of survival in multivariable analysis, and were combined to derive a prognostic index. The accuracy of the prognostic index was assessed both on the original cohort, and a validation set of 194 patients from another institutional prospective database. The AUROC scores for predicting the overall survival at 3 years were 0.77 in the derivation cohort and 0.74 in the validation cohort.CONCLUSION: The Pancreaticoduodenectomy Prognostic Index is a validated clinico-pathological model based on tumour site, T-stage and LNR to predict long-term survival following PD.

AB - BACKGROUND: Site of tumour origin, lymph node metastases and lymph node ratio (LNR) are identified as important factors determining prognosis in patients undergoing pancreaticoduodenectomy (PD). This study hypothesised that a prognostic index to predict survival could be developed through statistical modelling based on these pathological variables.METHODS: Patients who underwent PD between 2004 and 2013 were included. Univariable and multivariable (Cox regression) analyses were performed to identify predictors of survival, and a prognostic index was derived. The prognostic index was then validated using an external patient cohort.RESULTS: A total of 567 patients who underwent PD were used as a derivation cohort. Tumour site (p < 0.001), tumour size (p = 0.002), T-stage (p < 0.001), vascular involvement (p = 0.002), number of positive nodes (p < 0.001) and LNR (p < 0.001) were significantly associated with survival in univariable analysis. LNR (p < 0.001), tumour site (p < 0.001), T-stage (p = 0.007) remained significant predictors of survival in multivariable analysis, and were combined to derive a prognostic index. The accuracy of the prognostic index was assessed both on the original cohort, and a validation set of 194 patients from another institutional prospective database. The AUROC scores for predicting the overall survival at 3 years were 0.77 in the derivation cohort and 0.74 in the validation cohort.CONCLUSION: The Pancreaticoduodenectomy Prognostic Index is a validated clinico-pathological model based on tumour site, T-stage and LNR to predict long-term survival following PD.

U2 - 10.1016/j.hpb.2015.11.008

DO - 10.1016/j.hpb.2015.11.008

M3 - Article

C2 - 27037202

SN - 1365-182X

VL - 18

SP - 332

EP - 338

JO - HPB : the official journal of the International Hepato Pancreato Biliary Association

JF - HPB : the official journal of the International Hepato Pancreato Biliary Association

IS - 4

ER -

A model to predict survival following pancreaticoduodenectomy for malignancy based on tumour site, stage and lymph node ratio

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