title: The modified Glasgow Prognostic Score (mGPS) is a good predictor of indication for palliative bypass surgery in patients with unresectable pancreatic and biliary cancers.
abstract: BACKGROUND
  Patients with unresectable pancreatic and biliary cancers sometimes need decompression due to obstruction of the gastrointestinal tract and/or biliary tract. The aim of this study was to determine the prognostic factors associated with an indication for palliative bypass surgery in patients with unresectable pancreatic and biliary cancers.
  
  
  METHODS
  Between April 2005 and September 2011, 37 patients with unresectable pancreatic and biliary cancers underwent palliative bypass surgery. Prognostic factors were searched for among clinical characteristics, operation-related factors, and tumor-related factors using a prospective database.
  
  
  RESULTS
  The median survival time (MST) of these patients was 4.6 months, with a 6-month survival rate of 40.5 %. A multivariate Cox proportional hazards regression analysis revealed that mGPS >2 was the only independent prognostic factor for bypass surgery. Patients with an mGPS of 2 had an MST of 1.7 months, and they had a significantly worse prognosis than mGPS 0-1 patients with an MST of 6.3 months.
  
  
  CONCLUSIONS
  The mGPS is useful for predicting survival after surgical decompression due to gastrointestinal obstruction in patients with unresectable pancreatic and biliary cancers. Patients with a poor mGPS may not be indicated for palliative bypass surgery.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ikuta
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hashimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kuroki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sakata
authors.forename: Keita
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kanemitsu
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D015904:Biliopancreatic Diversion; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate