title: The Surgical Apgar Score Is an Independent Prognostic Factor in Patients with Pancreatic Cancer Undergoing Pancreatoduodenectomy Followed by Adjuvant Chemotherapy.
abstract: BACKGROUND
  We investigated the impact of the surgical Apgar score (SAS) on survival in patients with pancreatic cancer and recurrence after curative surgery followed by adjuvant chemotherapy.
  
  
  METHODS
  This study included 103 patients who underwent curative surgery for pancreatic cancer between 2005 and 2014. Patients with a SAS of 0-4 were classified into the low SAS group, while those with a SAS of 5-10 were classified into the high SAS group. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified.
  
  
  RESULTS
  The OS rates at 3 and 5 years after surgery were 23.0% and 14.4%, respectively, in the low-SAS group and 32.3% and 21.4%, respectively, in the high-SAS group, which was a statistically significant difference (p=0.039). The RFS rates at 3 and 5 years after surgery were 13.1% and 13.1%, respectively, in the low-SAS group and 21.4% and 19.2%, respectively, in the high-SAS group, which was a marginally significant difference (p=0.100). Multivariate analysis demonstrated that the SAS was a significant independent risk factor for OS and a marginally significant risk factor for RFS.
  
  
  CONCLUSIONS
  The SAS was a risk factor for OS in patients who underwent curative surgery followed by adjuvant chemotherapy for pancreatic cancer. The surgical procedure, perioperative care and surgical strategy should be carefully planned to improve survival.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan aoyamat@kcch.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kazama
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Murakawa
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Atsumi
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Shiozawa
authors.affiliation: Department of Gastrointestinal Medicine, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Gastrointestinal Medicine, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Department of Gastrointestinal Medicine, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Morinaga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
keywords: Pancreatic cancer; recurrence; surgical Apgar score; survival