title: The McGill Brisbane Symptom Score in relation to survival in pancreatic adenocarcinoma: a validation study.
abstract: The McGill Brisbane Symptom Score (MBSS) is a clinical score for pancreatic cancer patients upon initial presentation that takes into account four variables (weight loss, abdominal pain, jaundice, and history of smoking) to stratify them into two MBSS intensity categories. Several studies have suggested that these categories are strongly associated with eventual survival in patients with resectable (rPCa) and unresectable (uPCa) pancreatic cancer. This study aimed to validate the MBSS in a cohort of patients with pancreatic cancer from a single institution.
  
  
  
  Survival time by resection status and MBSS intensity category were analyzed among 633 patients from our institution between 2001 and 2010. Hazard ratios for death using Cox proportional hazards models, with age as the timescale, adjustment for sex and year of diagnosis, and stratified by adjuvant chemotherapy status were estimated.
  
  
  
  Median survival time was the longest in patients with low-intensity MBSS and rPCa (817 days), whereas the shortest survival time was found among patients with uPCa regardless of MBSS status (144-147 days). After consideration of age and chemotherapy status, high-intensity MBSS was associated with poorer survival for both rPCa (HR 1.64; 95 % CI 1.07-2.52) and uPCa (HR 1.35; 95 % CI 1.06-1.72).
  
  
  
  Preoperative MBSS intensity is a useful prognostic indicator of survival in resectable as well as unresectable pancreatic cancer.
authors.affiliation: Research School of Population Health, Australian National University, Canberra, ACT, 2601, Australia.|College of Medicine, Qatar University, Doha, Qatar.
authors.forename: Suhail A R
authors.initials: SA
authors.lastname: Doi
authors.affiliation: Research School of Population Health, Australian National University, Canberra, ACT, 2601, Australia.
authors.forename: Luis
authors.initials: L
authors.lastname: Furuya-Kanamori
authors.affiliation: Department of Hematology/Oncology, Marshfield Clinic Weston Center, 3501 Cranberry Boulevard, Weston, WI, 54476, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Engel
authors.affiliation: Department of Surgery, Kuwait University and Mubarak Alkabeer University Hospital, Kuwait City, Kuwait.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Jamal
authors.affiliation: Office of Scientific Writing and Publication, Marshfield Clinic Weston Center, Weston, WI, 54476, USA.
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Stankowski
authors.affiliation: The McGill University Health Centre (Surgery), Royal Victoria Hospital, Montreal, QC, H3A-1A1, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Barkun
authors.affiliation: Department of Hematology/Oncology, Marshfield Clinic Weston Center, 3501 Cranberry Boulevard, Weston, WI, 54476, USA. onitilo.adedayo@marshfieldclinic.org.
authors.forename: Adedayo A
authors.initials: AA
authors.lastname: Onitilo
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007565:Jaundice / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D012907:Smoking / Q000401:mortality; D015431:Weight Loss; D055815:Young Adult
keywords: Adenocarcinoma; McGill Brisbane Symptom Score; Non-resectable; Pancreatic neoplasms; Resectable; Unresectable; Validation