Background: Clinical tools that predict pancreatic adenocarcinoma (PAC) survival to help tailor treatments are lacking. Our surgical group has developed a clinical score, the McGill Brisbane Symptom Score (MBSS) that predicts PAC survival in resectable and non-resectable PAC. CA 19-9, a biomarker used in the diagnosis of PAC, has demonstrated increased potential as a predictor of PAC survival.Objectives: To determine if the Pancreatic Adenocarcinoma Survival Score (PACSS), a combined score of the CA 19-9-to-bilirubin ratio and the MBSS, better predicts survival in patients with resectable pancreatic cancer compared to the MBSS alone. Methods: A retrospective chart review of 122 patients treated at the McGill University Health Center (MUHC) and the University Hospital Zurich (UHZ) was undertaken. For all patients we calculated the MBSS and the PACSS at the time of diagnosis and ascertained the 2-year survival. Results: Both the MBSS and the PACSS were strong predictors of survival with Hazard Ratios (HR) of 2.58 (95%CI 1.35-4.91) and 3.06 (95%CI 1.64 - 5.70), respectively. Adding the patient age and sex, two other variables available at the time of diagnosis did not significantly improve the predictive ability of the models containing either the PACSS or the MBSS. Conclusions: Adding the CA 19-9-to-bilirubin ratio to the MBSS to form the PACSS may improve the predictive ability when compared to the MBSS alone. However the overlap in the 95% confidence intervals does not allow us to conclude that the difference is statistically significant. / Mise en contexte : Il existe peu d'outils cliniques permettant de prédire la survie des patients souffrant d'adénocarcinome du pancréas (ACP). Notre groupe a développé un score clinique, le McGill Brisbane Symptom Score (MBSS) permettant de prédire la survie chez les patients souffrant d'ACP resequable et non resequable. Objectifs Cette étude a pour but de déterminer si un score combinant le ratio Ca 19-9 sur bilirubine et le MBSS soit le the Pancreatic Adenocarcinoma Survival Score (PACSS), prédit mieux le survie chez les patients avec un ACP resequable compare uniquement au MBSS. Méthodes Une revue de dossiers rétrospective chez 122 patients traite au McGill University Health Center (MUHC) et au University Hospital Zurich (UHZ) fut entreprise. Pou tout les patients on a calcule le MBSS et le PACSS au moment du diagnostic et avons déterminé la survie a 2 ans. Résultats Le MBSS est un bon prédicteur de survie avec un (HR) de 2.58 (95%IC 1.35-4.91). Le PACSS fut le plus puissant prédicteur indépendant de survie avec un HR of 3.06 (95%IC 1.64 - 5.70). En ajoutant l'âge et le sexe, le pouvoir prédictif des deux modèles n'est pas amélioré. Conclusions En ajoutant le ratio Ca 19-9 sur bilirubine au MBSS pour former le PACSS peut améliorer le pouvoir prédictif compare au MBSS. Cependant du a une superposition des intervalles de confiance, nous ne pouvons conclure sur la significance statistique de cette différence.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.116938 |
| Date | January 2013 |
| Creators | Dumitra, Sinziana |
| Contributors | Jeffrey S T Barkun (Internal/Cosupervisor2), Maida Sewitch (Internal/Supervisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | Electronically-submitted theses. |
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