Pooling of prognostic studies in cancer of the pancreatic head and periampullary region: the Triple-P study. Triple-P study group.
OBJECTIVE
Development of a prognostic tool for patients with unresectable pancreatic cancer to distinguish between with low or high probabilities of survival 3 to 9 months after diagnosis.


METHODS
Data about individual patients from five studies were pooled. A multivariate proportional hazards model with time-dependent covariates was developed, including age, sex, and metastases. An extended model was developed on a subset of patients, including weight loss, pain, and jaundice at diagnosis.


METHODS
Multicentre study, The Netherlands, Norway, USA, UK, and Canada.


METHODS
1020 patients with unresectable pancreatic cancer.


METHODS
Prediction of prognosis.


RESULTS
Patients with metastases, pain, or weight loss at diagnosis had a significantly poorer prognosis than the others. Older men had a worse prognosis than younger men, while older women had a better prognosis than younger ones. Patients with jaundice had a relatively good prognosis. Differences in survival among the studies were incorporated in a prognostic score chart.


CONCLUSIONS
The prognostic score chart can be used to select patients with relatively low expectation of survival for endoscopic palliation, and patients with relatively high expectation for surgical palliation.
Terwee
C B
CB
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, The Netherlands.
Nieveen Van Dijkum
E J
EJ
Gouma
D J
DJ
Bakkevold
K E
KE
Klinkenbijl
J H
JH
Wade
T P
TP
van Wagensveld
B A
BA
Wong
A
A
van der Meulen
J H
JH
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate