Construction and Validation of a Prognostic Index for Patients With Metastatic Pancreatic Adenocarcinoma

Objectives: To identify prognostic factors in patients with metastatic pancreatic adenocarcinoma. Methods: The relationship between patient characteristics and outcome was examined by multivariate regression analyses of data from 409 consecutive patients with metastatic pancreatic adenocarcinoma who had been treated with a gemcitabine-containing regimen, and we stratified the patients into 3 risk groups according to the number of prognostic factors they had for a poor outcome. A validation data set obtained from 145 patients who had been treated with agents other than gemcitabine was analyzed. The prognostic index was applied the each of the patients. Results: The multivariate regression analyses revealed that the presence of pain, peritoneal dissemination, liver metastasis, and an elevated serum C-reactive protein value significantly contributed to a shorter survival time. The patients were stratified into 3 groups according to their number of risk factors, and their outcomes of the 3 groups were significantly different. When the prognostic index was applied to the validation data set, the respective outcomes of the 3 groups were found to be significantly differed from each other. Conclusions: Pain, peritoneal dissemination, liver metastasis, and an elevated serum C-reactive protein value are important prognostic factors for patients with metastatic pancreatic adenocarcinoma.