Hank et al reported the PANAMA score for predicting survival in a patient undergoing resection of a pancreatic cancer after preoperative chemotherapy. The authors are from Massachusetts General Hospital, Harvard Medical School and Heidelberg University.
PANAMA is an acronym derived from pancreatic, neoadjuvant, and Massachusetts.
Patient selection: preoperative chemotherapy followed by resection of a pancreatic carcinoma
Parameters:
(1) tumor size in mm
(2) number of positive lymph nodes (LN)
(3) R-status (residual tumor)
(4) serum CA19-9 in U/mL
Parameter
Finding
Points
tumor size
<= 20 mm
0
21 to 30 mm
1
31 to 40 mm
2
> 40 mm
3
number of positive LN
0 or 1
0
2 or 3
1
>= 4
2
R status of resected tumor
R0 (no residual tumor)
0
R1 (residual tumor)
2
serum CA19-9
< 37 U/mL
0
>= 37 U/mL
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
Score
Risk Group
Median Overall Survival
<= 2
low
45 months
3 to 5
intermediate
27 months
6 to 8
high
12 months
Performance:
• The area under the ROC curve at 2 years was 0.63 for the training and 0.68 for the validation cohorts.
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