title: Serum calcium level used as a prognostic predictor in patients with resectable pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  There is a relative scarcity of reports to evaluate the associations between serum calcium level and the prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to determine whether serum calcium level is a significant predictor for survival in PDAC patients.
  
  
  METHODS
  This is a retrospective cohort study. The clinicopathological characteristics, preoperative serum calcium levels and the survival data of 114 patients who underwent surgery for PDAC between January 1, 2009 and January 31, 2012 were collected. The associations between serum calcium level and overall survival were evaluated using the multivariate Cox proportional hazards model.
  
  
  RESULTS
  The median age of the patients was 60 years, and 64 (56.1%) of them were male. Eighty-one cases (71.1%) were dead at the last follow up. Forty-four patients (38.6%) died within the first year after surgery. The receiver operating characteristics (ROC) curve indicated a significant result for serum calcium level in predicting one-year death after surgery [area under the curve (AUC), 0.629; 95% CI 0.527-0.730, P=0.021]. In multivariate analysis, higher serum calcium levels [hazard ratio (HR), 1.922; P=0.036], diabetes (HR, 1.820; P=0.017), histologically poorly-differentiated tumor (HR, 3.342; P=0.001) and vessel invasion (HR, 1.729; P=0.023) were independent predictors of poor prognosis. Similarly, the albumin-adjusted albumin level was also an independent prognostic factor.
  
  
  CONCLUSIONS
  The higher serum calcium level is associated with poor prognosis in patients with resectable PDAC and the level of serum calcium can predict death within one year after surgery.
authors.affiliation: Department of Oncology, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District, Shenyang 110004, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China. Electronic address: dongqian08@163.com.
authors.forename: Xiang-Hong
authors.initials: XH
authors.lastname: Yang
authors.affiliation: Department of Oncology, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District, Shenyang 110004, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jing
authors.affiliation: Library, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District Shenyang 110004, China.
authors.forename: Li-Qiang
authors.initials: LQ
authors.lastname: Zheng
authors.affiliation: Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China.
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Liu
authors.affiliation: Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China.
authors.forename: Xiu-Juan
authors.initials: XJ
authors.lastname: Qu
authors.affiliation: Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
mesh_terms: D000368:Aged; D002118:Calcium / Q000097:blood*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002118:Calcium