Muttillo et al reported the PHT (Pancreatic Head Tumor) score for evaluating a patient with a carcinoma of the head of the pancreas. This can help to identify a patient with a worse prognosis. The authors are from Sapienza University of Rome and IRCCS Regina Elina National Cancer Institue.
Patient selection: cancer of the head of the pancreas
Parameters:
(1) primary tumor
(2) diameter of Wirsung duct (main pancreatic duct) in mm
(3) serum CA19.9 in U/mL
Parameter
Finding
Points
primary tumor
pancreatic duct adenocarcinoma
1
distal cholangiocarcinoma
0
Wirsung duct
<= 3 mm
0
> 3 mm
1
CA19.9
<= 230 U/mL
0
> 230 U/mL
2
where:
• The cut-off for serum CA19.9 could change depending on the assay.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score of 3 or 4 was associated with a worse prognosis.
• The 5-year survival was 0% for pancreatic duct adenocarcinoma vs 20% for distal cholangiocarcinoma.
Performance:
• The area under the ROC curve is 0.76.
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