title: Pooling of prognostic studies in cancer of the pancreatic head and periampullary region: the Triple-P study. Triple-P study group.
abstract: 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.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: C B
authors.initials: CB
authors.lastname: Terwee
authors.forename: E J
authors.initials: EJ
authors.lastname: Nieveen Van Dijkum
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: K E
authors.initials: KE
authors.lastname: Bakkevold
authors.forename: J H
authors.initials: JH
authors.lastname: Klinkenbijl
authors.forename: T P
authors.initials: TP
authors.lastname: Wade
authors.forename: B A
authors.initials: BA
authors.lastname: van Wagensveld
authors.forename: A
authors.initials: A
authors.lastname: Wong
authors.forename: J H
authors.initials: JH
authors.lastname: van der Meulen
mesh_terms: 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